Effect of Remote Ischemic Preconditioning on Serum Troponin T level Following Elective Percutaneous Coronary Intervention
Effect of Remote Ischemic Preconditioning on Serum Troponin T level Following Elective Percutaneous Coronary Intervention
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DOI：
10.1002/ccd.24825
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发表时间：
2013-11-01
影响因子：
2.3
通讯作者：
Mohamed, Tahir I.
中科院分区：
文献类型：
--
作者：
Ahmed, Rashed M.;Mohamed, El-Haddad A.;Mohamed, Tahir I.
背景选择性经皮冠状动脉介入治疗（PCI）与心肌坏死有关，在大约三分之一的病例中，肌钙蛋白的释放可以证明这一点。已知这与随后的心血管事件有关。本研究评估了远程缺血预处理（RIPC）的能力，以减轻心肌肌钙蛋白T（cTnT）释放后，选择性PCI. ESTA评价RIPC对心肌标志物后electivePCI.Methods149例连续接受择期PCI与不可检测的术前cTnT的患者被招募。受试者在到达心导管室之前立即随机接受RIPC（通过上臂周围的血压袖带的三次5分钟充气至200 mm Hg，然后再灌注5分钟间隔）或对照（袖带放气）。主要结局是PCI后约16小时的cTnT水平。次要结果包括术后心肌梗死（MI）的发生，CKMB水平在PCI后16小时和炎症反应的评估，测量C-反应蛋白（CRP）levels.ResultsThe平均cTnT在PCI后16小时的RIPC组与对照组相比，较低。（0.020 vs.0.047 ng/ml; P=0.047）两组术后MI、CKMB和CRP水平无差异（P=0.097、0.537和0.481）。结论PCI术前即刻使用RIPC可减弱手术相关cTnT释放，不影响术后MI、CKMB或CRP水平的发生。(c)2013 Wiley Periodicals，Inc.
BackgroundElective percutaneous coronary intervention (PCI) is associated with myocardial necrosis, as evidenced by troponin release, in approximately one-third of cases. This is known to be linked with subsequent cardiovascular events. This study assessed the ability of remote ischemic preconditioning (RIPC) to attenuate cardiac troponin T (cTnT) release after elective PCI.ObjectiveEvaluation of effect of RIPC on myocardial markers following elective PCI.MethodsOne hundred and forty nine consecutive patients undergoing elective PCI with undetectable preprocedural cTnT were recruited. Subjects were randomized to receive RIPC (induced by three 5-min inflations of a blood pressure cuff to 200 mm Hg around the upper arm, followed by 5-min intervals of reperfusion) or control (cuff deflated) immediately before arrival in the cardiac catheterization room. The primary outcome was cTnT level at approximately 16 hr after PCI. Secondary outcomes included occurrence of postprocedural myocardial infarction (MI), CKMB levels at 16 hr after PCI and assessment of the inflammatory response as measured by C-reactive protein (CRP) levels.ResultsThe mean cTnT at 16 hr after PCI was lower in the RIPC group compared with the control group. (0.020 vs. 0.047 ng/ml; P=0.047) Occurrence of postprocedural MI, CKMB and CRP levels did not differ in both groups (P=0.097, 0.537, and 0.481 respectively).ConclusionThe use of RIPC immediately prior to PCI attenuates procedure-related cTnT release and does not affect occurrence of post procedural MI, CKMB, or CRP levels. (c) 2013 Wiley Periodicals, Inc.