J Cardiovasc Interv.  2022 Jan;1(1):28-39. 10.54912/jci.2021.0003.

Effects of Remote Ischemic Conditioning on Late Infarct Size and Left Ventricular Function in Patients with ST-segment Elevation Myocardial Infarction

• Youn YJ
• Cho DH
• Park YJ
• Son JW
• Lee JW
• Ahn MS
• Ahn SG
• Kim JY
• Yoo BS
• Lee SH
• Yoon J

• KMID: 2561238
• DOI: http://doi.org/10.54912/jci.2021.0003

Abstract

Background
Remote ischemic conditioning (RIC) in ST-segment elevation myocardial infarction (STEMI) patients was demonstrated to reduce reperfusion injury on early cardiovascular magnetic resonance (CMR). However, data on late CMR are limited. This study evaluated whether the RIC could reduce the infarct size and improve the left ventricular (LV) function on CMR at 3–5 days and at 6 months in STEMI patients.
Methods
Patients with STEMI were randomized to either the control or the RIC group. RIC, which comprised four 5-minute cycles of inflation and deflation of the blood cuff around the upper arm, was started upon arrival at the catheterization laboratory. Infarct size and LV function were evaluated using CMR at 3–5 days and at 6 months after primary percutaneous coronary intervention (PPCI).
Results
Forty-nine patients in the control group and 48 patients in the RIC group were analyzed. The baseline clinical and angiographic characteristics were not different between the 2 groups. The rate of final thrombolysis in myocardial infarction flow grade, myocardial blush grade, enzymatic infarct size, and ST-segment resolution was similar between the 2 groups. Infarct size and LV functions on CMR at 3–6 days and at 6 months showed no difference between the 2 groups.
Conclusions
This randomized trial showed that RIC did not affect the infarct size or improve the LV function on early and late CMR in patients with STEMI undergoing PPCI.

Keyword

Magnetic resonance imaging; Percutaneous coronary intervention; Randomized controlled trial; Reperfusion injury; ST elevation myocardial infarction