关键词: 晚期时相肢体缺血预适应, 缺血预适应, 冠状动脉介入术, 肌钙蛋白I

Abstract:

Objective To assess whether late-phase limb ischemia preconditioning (L-LIP) is effective in myocardial protection in patients with coronary heart disease undergoing elective percutaneous coronary intervention (PCI) and improve the prognosis at 6 months after PCI. Methods A total of 200 patients planned to PCI treatment admitted into our hospital from January 2010 to December 2013 were enrolled and divided randomly into L-LIP (98 patients) (induced by three 5-minute inflations of a blood pressure cuff to 200 mmHg around the upper arm, followed by 5-min intervals of reperfusion) or control (102 patients) at 24 h before PCI. Data of PCI, creatine phosphokinase (CK), its cardiac isoenzyme (CK-MB), troponin I (TnI), and high-sensitivity C-reactive protein (hs-CRP) levels were measured at 24 h after PCI. Adverse events' rates at 6 months were assessed. Results Patients in L-LIP group had significantly lower incidences of Chest pain score >1 and ECG ST deviation> 1 mm (P <0.05). The median TnI, CK, and CK-MB concentrations at 24 h were lower in the L-RIPC group (0.009 vs 0.036 ng/mL, 123 vs 186 IU/L, 15 vs 27 IU/L; P <0.05). Excluding patient with side branch occlusion, cTnI, CK, and CK-MB were also lower in the L-LIP group (0.008 vs 0.040 ng/mL, 126 vs 191 IU/L, 16 vs 28 IU/L; P <0.05). Kaplan-Meier plots demonstrated a significant decrease in adverse events' rate in L-LIP group (χ²=4.374, P=0.036). Conclusion L-LIP is effective in myocardial protection in patients undergoing elective PCI and reduces adverse events' rate at 6 months.

Key words: late-phase of 1imb ischemia preconditioning, ischemia preconditioning, percutaneous coronary intervention, troponin I