TY - JOUR
T1 - Tobacco smoking protective effect via remote ischemic preconditioning on myocardial damage after elective percutaneous coronary intervention
T2 - Subanalysis of a randomized controlled trial
AU - RINC Study Collaborators
AU - Ejiri, Kentaro
AU - Miyoshi, Toru
AU - Kohno, Kunihisa
AU - Nakahama, Makoto
AU - Doi, Masayuki
AU - Munemasa, Mitsuru
AU - Murakami, Masaaki
AU - Takaishi, Atsushi
AU - Nakamura, Kazufumi
AU - Ito, Hiroshi
N1 - Funding Information:
This study was funded by the Okayama Medical Foundation, which is a nonprofit institution. The Okayama Medical Foundation was not involved in the study design; conduction of the study; collection, analysis, and interpretation of the data; writing of the report; or the decision to submit the article for publication.
Funding Information:
This study was supported by Okayama Medical Foundation .
PY - 2019/3
Y1 - 2019/3
N2 - Background: Remote ischemic preconditioning (RIPC) is promising for preventing periprocedural myocardial damage (pMD) in patients undergoing percutaneous coronary intervention (PCI). However, the impact of RIPC on pMD on smokers is not well elucidated. The aim of this study was to investigate an association between tobacco smoking and RIPC on pMD in patients planning to undergo PCI. Methods: This study used data from a multicenter randomized controlled trial involving patients with stable angina who planned to undergo elective PCI. We analyzed data for 262 patients in the control (n = 133) and upper-limb RIPC (n = 129) groups, including 166 current or former smokers. The major outcome was the pMD incidence following PCI, with pMD defined as an elevated level of highly sensitive cardiac troponin T or a creatine kinase myocardial band 12 or 24 h after PCI. Results: The incidence of pMD was significantly lower in the upper-limb RIPC group than in the control group (28/83 patients [33.8%] vs. 43/83 patients [51.8%], respectively; p = 0.018). In a multiple logistic regression model, tobacco smoking was an independent predictor of interacting with and enhancing the effect of RIPC on reducing the incidence of pMD after PCI (regression coefficient, −0.4 [95% confidence interval, −0.74 to −0.082]; p = 0.015). Conclusions: Tobacco smoking may have a beneficial effect on RIPC against pMD after PCI.
AB - Background: Remote ischemic preconditioning (RIPC) is promising for preventing periprocedural myocardial damage (pMD) in patients undergoing percutaneous coronary intervention (PCI). However, the impact of RIPC on pMD on smokers is not well elucidated. The aim of this study was to investigate an association between tobacco smoking and RIPC on pMD in patients planning to undergo PCI. Methods: This study used data from a multicenter randomized controlled trial involving patients with stable angina who planned to undergo elective PCI. We analyzed data for 262 patients in the control (n = 133) and upper-limb RIPC (n = 129) groups, including 166 current or former smokers. The major outcome was the pMD incidence following PCI, with pMD defined as an elevated level of highly sensitive cardiac troponin T or a creatine kinase myocardial band 12 or 24 h after PCI. Results: The incidence of pMD was significantly lower in the upper-limb RIPC group than in the control group (28/83 patients [33.8%] vs. 43/83 patients [51.8%], respectively; p = 0.018). In a multiple logistic regression model, tobacco smoking was an independent predictor of interacting with and enhancing the effect of RIPC on reducing the incidence of pMD after PCI (regression coefficient, −0.4 [95% confidence interval, −0.74 to −0.082]; p = 0.015). Conclusions: Tobacco smoking may have a beneficial effect on RIPC against pMD after PCI.
KW - Ischemic preconditioning
KW - Myocardial damage
KW - Percutaneous coronary intervention
KW - Tobacco
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U2 - 10.1016/j.ijcha.2018.12.005
DO - 10.1016/j.ijcha.2018.12.005
M3 - Article
AN - SCOPUS:85058774870
VL - 22
SP - 55
EP - 60
JO - IJC Heart and Vasculature
JF - IJC Heart and Vasculature
SN - 2352-9067
ER -