Efficacy of comprehensive remote ischemic conditioning in elderly patients with acute ST-segment elevation myocardial infarction underwent primary percutaneous coronary inter-vention
Yan-Ling WANG1
Qi YANG2
Cheng-Yan HU1
Yan-Yan CHU1
Zheng SUN3
Huan ZHAO1
Zhi LIU1
1.Department of Cardiology,Xuanwu Hospital,Capital Medical University,Beijing,China2.Department of Radiology,Chaoyang Hospital,Capital Medical University,Beijing,China3.Department of Radiology,Xuanwu Hospital,Capital Medical University,Beijing,China
摘要：BACKGROUND Remote ischemic conditioning (RIC) is used to protect against myocardial injury. However, there is no adequ-ate evidence for comprehensive RIC in elderly patients with ST-segment elevation myocardial infarction (STEMI). This study ai-med to test whether comprehensive RIC, started pre-primary percutaneous coronary intervention (PPCI) and repeated daily on 1–30 days post-PPCI, can improve myocardial salvage index (SI), left ventricular ejection fraction (LVEF), Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS) and 6-min walk test distance (6MWD) in elderly patients with acute STEMI during 12 months follow-up. METHODS 328 consenting elderly patients were randomized to receive standard PPCI plus comprehensive RIC (the treatment group) or standard PPCI (the control group). SI at 5–7 days after PPCI, LVEF, left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), KCCQ-CSS, 6MWD and adverse events rates were measured and assessed. RESULTS SI was significantly higher in the treatment group [interquartile range (IQR): 0.38–0.66, P = 0.037]. There were no signif-icant differences in major adverse events at 12 months. Although the differences of LVEDVI, LVESVI and LVEF between the tre-atment group and the control group did not reach statistical significance at 6 months and 12 months, LVEF tended to be higher, LVEDVI tended to be lower in the treatment group. The KCCQ-CSS was significantly higher in the treatment group at 1 month (IQR: 46.5–87, P = 0.001) and 12 months (IQR: 55–93, P = 0.008). There was significant difference in 6MWD between the treatment group and the control group (IQR: 258–360 vs. IQR: 250–345, P = 0.002) at 1 month and (IQR: 360–445 vs. IQR: 345–432, P = 0.035) at 12 months. A modest correlation was found between SI and LVEF (r = 0.452, P < 0.01), KCCQ-CSS (r = 0.440, P < 0.01) and 6MWD (r = 0.384, P < 0.01) respectively at 12 months. CONCLUSIONS The comprehensive RIC can improve SI, KCCQ-CSS and 6MWD. It may be an adjunctive therapy to PPCI in elderly patients with STEMI.
机标关键词：st-segmentpercutaneouswithacutecomprehensiveconditioningcoronaryefficacy
论文发表日期：2022-06-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 435-444 )