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Remote ischemic postconditioning failed to reduce elective PCI damage
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Remote ischemic conditioning yielded similar peak troponin I levels as placebo in a cohort of patients undergoing PCI for angina.
The aim of the single-center, randomized clinical trial was to evaluate the capacity of remote ischemic postconditioning to prevent PCI-related MI.
The study included 232 patients who underwent PCI for stable or unstable angina at a tertiary care center. The two study arms included patients treated with remote ischemic postconditioning (n=118) or those given placebo (n=114).
The peak troponin I level at 24 hours served as the primary outcome measure. The researchers defined PCI-related MI as an elevation of troponin values >3 or >5 of the 99th percentile according to the classical or new definitions.
Hospital admission, PCI for stable angina or ACS and mortality at 1 year served as secondary outcome measures. The researchers also evaluated the role of remote ischemic postconditioning among patients with diabetes.
Treatment yielded a peak troponin level of 0.476 ng/mL compared with 0.478 ng/mL in the placebo group (P=.99). Thirty-six percent of patients in the treatment group experienced PCI-related MI compared with 30.8% in those given placebo (P=.378).
There was more PCI-related MI in the cohort of patients with diabetes (OR=2.7; 95% CI, 1.10-6.92). Using the 2012 definition for PCI-related MI, researchers found that patients with diabetes treated with remote ischemic postconditioning had a significantly higher risk for PCI-related MI compared with diabetic controls (18.5% vs. 38.6%; OR=2.7; P=.027).
Secondary outcomes occurred in 11.7% of the remote ischemic postconditioning group and 10.8% of those who received placebo (P=.907).
The researchers concluded that remote ischemic postconditioning failed to yield reductions in damage from elective PCI or CV events during the course of follow-up.
Disclosure: The researchers report no relevant financial disclosures.
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