Effect of Remote Ischemic Postconditioning During Thrombolysis in STEMI

Herz. 2018 Mar;43(2):161-168. doi: 10.1007/s00059-017-4550-9. Epub 2017 Mar 17.

Abstract

Background: Remote ischemic postconditioning (RIPC) is suggested to protect the myocardium against ischemia in various settings. However, the effect of RIPC in patients with acute ST-elevation myocardial infarction (STEMI) who undergo thrombolysis has yet to be examined.

Patients and methods: In this single-center, randomized controlled trial, we examined the effect of RIPC on the resolution of ST-segment elevation (STR) in response to thrombolysis. Patients in the RIPC group had three cycles of 5‑min cuff inflation followed by 5‑min deflation to the upper arm.

Results: The study comprised 78 patients (15 women), of whom 41 were randomized to the RIPC group and 37 to the control group. STR occurred in 61% of the patients in the RIPC group, while it was detected only in 35% of controls (p = 0.026). Although STR was more common in the RIPC group, there was no difference in the extent of ΣCK-48 h between the two groups. Furthermore, the length of hospital stay and the frequency of adverse events were similar between the RIPC and control groups.

Conclusion: RIPC during thrombolytic therapy in STEMI was associated with a higher frequency of STR. However, it did not affect enzymatic infarct size or the frequency of adverse events. (Clinical trial registration number: IRCT2014011916229N2.).

Keywords: Ischemia; Myocardium; Reperfusion; ST-segment elevated myocardial infarction (STEMI); Thrombolytic therapy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Electrocardiography
  • Female
  • Humans
  • Ischemic Postconditioning / methods*
  • Male
  • Middle Aged
  • Prognosis
  • ST Elevation Myocardial Infarction / therapy*
  • Thrombolytic Therapy*