The Effect of Remote Ischemic Preconditioning on The Outcome of Elective Percutaneous Coronary Intervention

Abstract

Background: Remote ischemic preconditioning (IPC) is a potential cardioprotective strategy in the context of elective percutaneous coronary intervention (PCI). This study aimed to assess its impact on post-procedural cardiac myonecrosis, as measured by cardiac troponin I (cTnI), and its association with major adverse cardiac events (MACE) at 6-month follow-up. The objective of this study was to investigate whether remote IPC, administered prior to elective PCI, reduces cTnI levels, ischemic symptoms, ECG evidence of ischemia, and the occurrence of MACE. Methods: This prospective study was conducted involving 200 patients with significant coronary artery stenosis who underwent elective PCI. Patients were divided into two groups: Group A received remote IPC through blood pressure cuff inflations and deflations, while Group B served as the control. Various parameters, including patient demographics, cardiac risk factors, ECG findings, lesion complexity, and MACE rate, were assessed. Results: Both groups exhibited similar baseline characteristics, with no significant differences in age, gender, cardiac risk factors, ECG findings, and lesion complexity. Remote IPC was associated with a significant reduction in cTnI levels at 24 hours post-PCI and a lower incidence of unstable angina and overall MACE. No significant differences were observed in other procedural outcomes or adverse events between the groups. Conclusions: This study suggests that remote IPC administered prior to elective PCI has the potential to mitigate post-procedural cardiac damage, as indicated by reduced cTnI levels, and may be associated with a lower incidence of MACE.