Effect of remote ischaemic conditioning on infarct size and remodelling in ST-segment elevation myocardial infarction patients: the CONDI-2/ERIC-PPCI CMR substudy.
|
| Abstract |
The effect of limb remote ischaemic conditioning (RIC) on myocardial infarct (MI) size and left ventricular ejection fraction (LVEF) was investigated in a pre-planned cardiovascular magnetic resonance (CMR) substudy of the CONDI-2/ERIC-PPCI trial. This single-blind multi-centre trial (7 sites in UK and Denmark) included 169 ST-segment elevation myocardial infarction (STEMI) patients who were already randomised to either control (n = 89) or limb RIC (n = 80) (4 × 5 min cycles of arm cuff inflations/deflations) prior to primary percutaneous coronary intervention. CMR was performed acutely and at 6 months. The primary endpoint was MI size on the 6 month CMR scan, expressed as median and interquartile range. In 110 patients with 6-month CMR data, limb RIC did not reduce MI size [RIC: 13.0 (5.1-17.1)% of LV mass; control: 11.1 (7.0-17.8)% of LV mass, P = 0.39], or LVEF, when compared to control. In 162 patients with acute CMR data, limb RIC had no effect on acute MI size, microvascular obstruction and LVEF when compared to control. In a subgroup of anterior STEMI patients, RIC was associated with lower incidence of microvascular obstruction and higher LVEF on the acute scan when compared with control, but this was not associated with an improvement in LVEF at 6 months. In summary, in this pre-planned CMR substudy of the CONDI-2/ERIC-PPCI trial, there was no evidence that limb RIC reduced MI size or improved LVEF at 6 months by CMR, findings which are consistent with the neutral effects of limb RIC on clinical outcomes reported in the main CONDI-2/ERIC-PPCI trial.
|
|---|---|
| Authors | Rohin Francis, Jun Chong, Manish Ramlall, Chiara Bucciarelli-Ducci, Tim Clayton, Matthew Dodd, Thomas Engstrøm, Richard Evans, Vanessa M Ferreira, Marianna Fontana, John P Greenwood, Rajesh K Kharbanda, Won Yong Kim, Tushar Kotecha, Jacob T Lønborg, Anthony Mathur, Ulla Kristine Møller, James Moon, Alexander Perkins, Roby D Rakhit, Derek M Yellon, Hans Erik Bøtker, Heerajnarain Bulluck, Derek J Hausenloy |
| Journal | Basic research in cardiology (Basic Res Cardiol) Vol. 116 Issue 1 Pg. 59 (10 14 2021) ISSN: 1435-1803 [Electronic] Germany |
| PMID | 34648075 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't) |
| Copyright | © 2021. The Author(s). |
| Topics |
|
Join CureHunter, for free Research Interface BASIC access!
Realize the full power of the drug-disease research graph!