Remote ischaemic preconditioning reduces myocardial ischaemic reperfusion injury in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Abstract

Background Myocardial ischaemic reperfusion injury (IRI) increases infarct size and results in poor prognosis in ST-segment-elevation myocardial infarction (STEMI).Objectives The present study aims to determine whether remote ischaemic preconditioning (RIPC) alleviates myocardial IRI in STEMI patients undergoing primary percutaneous coronary intervention (PPCI).Methods One hundred and nineteen STEMI patients were randomly assigned to the PPCI group (patients receiving only PPCI) (n = 60) and R + PPCI group (patients receiving RIPC and PPCI) (n = 59). The primary study end point was early microvascular obstruction measured by cardiovascular magnetic resonance in all patients.Results RIPC improved the percentage of myocardial blush grade (2-3) (P =0.035) and left ventricular ejection fraction (P =0.039) in the R + PPCI group. Importantly, RIPC reduced early MO (MO, P= 0.011; MO%LV, P= 0.016) and infarct size (%LV, P= 0.042) in the R + PPCI group compared to the PPCI group.Conclusions The present study showed that RIPC before stenting alleviated myocardial IRI and reduced infarct size in patients with STEMI.