Effect of Remote Ischemic Preconditioning on the Periprocedural Myocardial Injury Events during Elective Percutaneous Coronary Intervention

Background: Periprocedural myocardial injury (PMI) occurs in at least a third of patients underwent elective percutaneous coronary intervention (PCI). Effect of remote ischemic preconditioning (rIPC) on the PMI and infarction remains elusive. Purpose of this study was to know the effect of rIPC on the PMI and infarction during PCI in patient with coronary artery disease (CAD) underwent elective PCI. Method: Forty-two patients with stable coronary artery disease underwent elective PCI were randomized into rIPC group (n= 20) and control group (n=22). RIPC protocol was 4 cycles of inflation-deflation using a blood pressure cuff 20 mmHg above the systolic blood pressure in one of the upper arm. Assessment of PMI was determined by increase of cardiac enzyme CK-MB at 18 to 24 hours post PCI. Result: The levels of CK-MB post PCI was significantly lower in the RIPC group than control, 25.15±5.46 vs. 40.59±21.16 μg/mL, respectively ("=0.003). Evidence of PMI was significant lower in the RIPC group than that of the control, 2.3% vs.19.04% ("=0.022), while that of the infarction was not significant difference between both groups, 0% vs. 2 (4.76%), respectively ("=0.489). Conclusion: Remote ischemic preconditioning may reduce periprocedural myocardial injury in patient with CAD underwent elective percutaneous coronary intervention.