Influence of Cardiovascular Risk Factors, Comorbidities, Medication Use and Procedural Variables on Remote Ischemic Conditioning Efficacy in Patients with ST-Segment Elevation Myocardial Infarction
Abstract
:1. Introduction
2. The Concept of RIC
3. Effect of RIC in Patients with STEMI
4. Influence of Cardiovascular Risk Factors, Patient Comorbidities and Characteristics and Medication Use on the Efficacy of RIC
Pre-Infarction Angina
5. Influence of PPCI-Procedural Variables on the Efficacy of RIC
5.1. Infarct Location, AAR of Infarction, Pre-Procedural TIMI Flow and Other PPCI-Procedural Variables
5.2. Coronary Collateral Blood Flow to the Infarct-Related Artery
5.3. Medication Administration in Relation to PPCI and PPCI Technique
5.4. Ischemia Duration and Health-Care System Delay
6. Conclusions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
AAR | Area-at-risk |
AMI | Acute myocardial infarction |
CCBF | Coronary collateral blood flow |
CMR | Cardiac magnetic resonance |
I-R | Ischemia-reperfusion |
LVEF | Left ventricular ejection fraction |
PIA | Pre-infarction angina |
PPCI | Primary percutaneous coronary intervention |
RIC | Remote ischemic conditioning |
SPECT | Single-photon emission computed tomography |
STEMI | ST-segment elevation myocardial infarction |
TIMI | Thrombolysis In Myocardial Infarction |
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Study | Patients | RIC Protocol | Effect of RIC on Primary Endpoint | Variables Influencing Efficacy of RIC on Primary Endpoint |
---|---|---|---|---|
Rentoukas [23], 2010 | n = 96 | 3 cycles of 4 min I-R of the upper arm during PPCI | Increased ST-segment resolution on electrocardiogram | N/A |
Bøtker [24], 2010 | n = 333 | 4 cycles of 5 min I-R of the upper arm prior to PPCI | Increased MSI assessed by SPECT | Effect modification from LAD artery infarction, AAR, pre-procedural TIMI flow, ischemia duration [25] and CCBF [26]. No observed effect modification from PIA [26], cardiovascular risk factors or concomitant medication use |
Crimi [27], 2013 | n = 100, only patients with LAD artery infarction, pre-procedural TIMI flow grade 0-1 and without CCBF | 3 cycles of 5 min I-R of the lower limb following PPCI | Reduction in cardiac biomarker release assessed by CK-MB | No observed effect modification from age, sex, diabetes mellitus, PIA, morphine administration, ischemia duration or multivessel disease |
Prunier [28], 2014 | n = 151, only patients with LAD or RCA artery infarction, pre-procedural TIMI flow grade 0-1 and without significant CCBF | 3 cycles of 5 min I-R of the upper arm prior to PPCI | Reduction in cardiac biomarker release assessed by CK-MB | N/A |
Manchurov [29], 2014 | n = 48, both patients with STEMI and NSTEMI | 4 cycles of 5 min I-R of the upper arm prior to PPCI | Improvement in peripheral endothelial function assessed by brachial artery flow-mediated dilation | N/A |
White [30], 2015 | n = 197, only patients with pre-procedural TIMI flow grade 0 and without CCBF | 4 cycles of 5 min I-R of the upper arm prior to PPCI | Reduction in MI size assessed by CMR | N/A |
Eitel [31], 2015 | n = 696 | 3 cycles of 5 min I-R of the upper arm prior to PPCI + ischemic postconditioning | Reduction in MSI assessed by CMR | No observed effect modification from sex, age, infarct location, AAR, pre-procedural TIMI flow, ischemia duration, Killip class, thrombectomy, direct stenting or GP IIb/IIIa inhibitor administration |
Yellon [32], 2015 | n = 519 | 4 cycles of 5 min I-R of the upper arm prior to thrombolysis | Reduction in cardiac biomarker release assessed by troponin T and CK-MB | N/A |
Verouhis [33], 2016 | n = 150, only patients with anterior infarction and without concomitant treatment with glibenclamide or cyclosporine | Cycles of 5 min I-R of the lower limb prior to and during PPCI | No effect on MSI assessed by CMR | No observed effect modification from smoking, LAD artery infarction, pre-procedural TIMI flow or ischemia duration |
Lotfollahi [34], 2016 | n = 82, only patients with age <80 years | 3 cycles of 4 min I-R of the upper arm during PPCI | Reduction in serum oxidative stress assessed by glutathione peroxidase | N/A |
Ladejobi [35], 2017 | n = 150, only patients with LVEF <55% and without hypotension | 4 cycles of 5 min I-R of the upper arm prior to PPCI | Reduction in incidence of in-hospital HF | No observed effect modification from presenting with cardiac arrest |
Ghaffari [36], 2017 | n = 78 | 3 cycles of 5 min I-R of the upper arm during to thrombolysis | Increased ST-segment resolution on electrocardiogram | N/A |
Elbadawi [37], 2017 | n = 71, only patients with anterior infarction | 3 cycles of 5 min I-R of the lower limb following PPCI | No effect on adverse left ventricular remodelling or LVEF assessed by echocardiography | N/A |
Cao [38], 2018 | n = 80, only patients without concomitant treatment with trimethoprim or glibenclamide | 4 cycles of 5 min I-R of the upper arm following PPCI | Reduction in cardiac biomarker release assessed by CK-MB | N/A |
Cao [39], 2018 | n = 72, only patients without concomitant treatment with trimethoprim or glibenclamide | 4 cycles of 5 min I-R of the upper arm following PPCI | Reduction in acute kidney injury assessed by serum creatinine | N/A |
Gaspar [40], 2018 | n = 258 | 3 cycles of 5 min I-R of the lower limb during PPCI | Reduction in the combined endpoint of cardiac mortality or rehospitalization for HF at 2-year follow-up | Effect modification from anterior MI, pre-procedural TIMI flow and ischemia duration |
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Pryds, K.; Hjortbak, M.V.; Schmidt, M.R. Influence of Cardiovascular Risk Factors, Comorbidities, Medication Use and Procedural Variables on Remote Ischemic Conditioning Efficacy in Patients with ST-Segment Elevation Myocardial Infarction. Int. J. Mol. Sci. 2019, 20, 3246. https://doi.org/10.3390/ijms20133246
Pryds K, Hjortbak MV, Schmidt MR. Influence of Cardiovascular Risk Factors, Comorbidities, Medication Use and Procedural Variables on Remote Ischemic Conditioning Efficacy in Patients with ST-Segment Elevation Myocardial Infarction. International Journal of Molecular Sciences. 2019; 20(13):3246. https://doi.org/10.3390/ijms20133246
Chicago/Turabian StylePryds, Kasper, Marie Vognstoft Hjortbak, and Michael Rahbek Schmidt. 2019. "Influence of Cardiovascular Risk Factors, Comorbidities, Medication Use and Procedural Variables on Remote Ischemic Conditioning Efficacy in Patients with ST-Segment Elevation Myocardial Infarction" International Journal of Molecular Sciences 20, no. 13: 3246. https://doi.org/10.3390/ijms20133246