Cardiac Remote Ischemic Preconditioning in Coronary Stenting (CRISP Stent) Study A Prospective, Randomized Control Trial
Cardiac Remote Ischemic Preconditioning in Coronary Stenting (CRISP Stent) Study A Prospective, Randomized Control Trial
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DOI：
10.1161/circulationaha.108.809723
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发表时间：
2009-02-17
期刊：
影响因子：
37.8
通讯作者：
Dutka, David P.
中科院分区：
文献类型：
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作者：
Hoole, Stephen P.;Heck, Patrick M.;Dutka, David P.
背景-选择性经皮冠状动脉介入治疗（PCI）导致的心肌细胞坏死发生在大约三分之一的病例中，并与随后的心血管事件有关。本研究评估了远程缺血预处理（IPC）的能力，以减轻心肌肌钙蛋白I（cTnI）释放后electivePCI.Methods和Results-Two 42例连续择期PCI与不可检测的术前cTnI患者被招募。在到达导管实验室之前，受试者被随机分配接受远程IPC（通过上臂周围的血压袖带充气至200 mm Hg，然后间隔5分钟进行再灌注）或对照（手臂周围的未充气袖带）。主要结局是PCI术后24小时的cTnI。次要结局包括6个月时的肾功能不全和主要不良心脑事件发生率。与对照组相比，远程IPC组PCI后24小时的中位cTnI较低（0.06 vs 0.16 ng/mL; P=0.040）。远程IPC后，cTnI为
Background-Myocyte necrosis as a result of elective percutaneous coronary intervention (PCI) occurs in approximately one third of cases and is associated with subsequent cardiovascular events. This study assessed the ability of remote ischemic preconditioning (IPC) to attenuate cardiac troponin I (cTnI) release after elective PCI.Methods and Results-Two hundred forty-two consecutive patients undergoing elective PCI with undetectable preprocedural cTnI were recruited. Subjects were randomized to receive remote IPC (induced by three 5-minute inflations of a blood pressure cuff to 200 mm Hg around the upper arm, followed by 5-minute intervals of reperfusion) or control (an uninflated cuff around the arm) before arrival in the catheter laboratory. The primary outcome was cTnI at 24 hours after PCI. Secondary outcomes included renal dysfunction and major adverse cardiac and cerebral event rate at 6 months. The median cTnI at 24 hours after PCI was lower in the remote IPC compared with the control group (0.06 versus 0.16 ng/mL; P=0.040). After remote IPC, cTnI was