Long‐term outcome following remote ischemic postconditioning during percutaneous coronary interventions—the RIP‐PCI trial long‐term follow‐up

• Published in: Clinical cardiology (Mahwah, N.J.) N.J.), 2017-05, Vol.40 (5), p.268-274
• Main Authors: Lavi, Shahar, Abu‐Romeh, Nour, Wall, Sabrina, Alemayehu, Mistre, Lavi, Ronit
• Format: Article
• Language: English
• Subjects: Aged; Angina, Stable - diagnosis; Angina, Stable - mortality; Angina, Stable - therapy; Angina, Unstable - diagnosis; Angina, Unstable - mortality; Angina, Unstable - therapy; Angioplasty; Arm - blood supply; Cardiac; catheterization/diagnostic interventional; Clinical Trial Updates; Clinical trials; Disease-Free Survival; Female; Heart attacks; Humans; Ischemia; Ischemic Preconditioning - adverse effects; Ischemic Preconditioning - instrumentation; Ischemic Preconditioning - methods; Ischemic Preconditioning - mortality; Male; Middle Aged; Myocardial Infarction - etiology; Myocardial Reperfusion Injury - etiology; Ontario; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - instrumentation; Percutaneous Coronary Intervention - mortality; Prospective Studies; Regional Blood Flow; Risk Factors; Stents; Thigh - blood supply; Time Factors; Tourniquets; Treatment Outcome
• ISSN: 0160-9289; 1932-8737
• DOI: 10.1002/clc.22668

The clinical value of ischemic conditioning during percutaneous coronary intervention (PCI) and mode of administration is controversial. Our aim was to assess the long‐term effect of remote ischemic postconditioning among patients undergoing PCI. We randomized 360 patients undergoing PCI who presented with a negative troponin T at baseline into 3 groups: 2 groups received remote ischemic postconditioning (with ischemia applied to the arm in 1 group and to the thigh in the other group), and the third group acted as a control group. Remote ischemic postconditioning was applied during PCI immediately following stent deployment, by 3, 5‐minute cycles of blood pressure cuff inflation to >200 mm Hg on the arm or thigh (20 mm Hg to the arm in the control), with 5‐minute breaks between each cycle. There were no differences in baseline characteristics among the 3 groups. Periprocedural myocardial injury occurred in 33% (P = 0.64). After 1 year, there was no difference between groups in death (P = 0.91), myocardial infarction (P = 0.78), or repeat revascularization (P = 0.86). During 3 years of follow‐up, there was no difference in death, myocardial infarction, and revascularization among the groups (P = 0.45). Remote ischemic postconditioning during PCI did not affect long‐term cardiovascular outcome. A similar effect was obtained when remote ischemia was induced to the upper or lower limb. ClinicalTrials.gov Identifier: NCT00970827