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Article Type

Original Study

Abstract

Objective The purpose of this study was to assess and compare different methods of remote ischemic preconditioning (RIPC) to reduce cardiac myonecrosis as measured by evaluating cardiac troponin I (cTnI) after elective percutaneous coronary intervention (PCI) and to reduce major adverse cardiac event rate at 6 months of follow-up. Background RIPC is a way to reduce cardiac myonecrosis. Patients and methods This study was conducted on 120 symptomatic patients with coronary heart disease who were scheduled for elective PCI. Patients were randomized into three groups: group A included 40 patients who underwent RIPC immediately before PCI through the upper arm; group B included 40 patients who underwent RIPC immediately before PCI through the upper thigh; and group C (the control group) included 40 patients with no RIPC. Results Results of the current study showed that ST-segment deviation during intervention was statistically significantly lower (P < 0.05) in the leg and arm groups versus the control group. Results of the current study showed that rise in cTnI was statistically significantly lower (P < 0.05) in the leg and arm groups versus the control group. However, no significant difference was found between the arm and leg groups as regards rise in cTnI. There was no significant difference between groups as regards the incidence of major adverse cardiac event at 6 months. Conclusion RIPC is a simple, cheap, well-tolerated procedure that has a significant effect on the reduction in postprocedural elevations of cTnI. RIPC increases the tolerance of the myocardium to ischemia, reduces ischemic chest discomfort during coronary balloon occlusion, reduces ST-segment deviation during intervention, reduces the rise in cTnI release after elective PCI, and appears to reduce subsequent cardiovascular events. RIPC using the upper thigh or upper arm has same protective effects on the myocardium.

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