Is Cardiac Remote Ischemic Preconditioning (RIPC) More Beneficial in Patients with Diabetes to Reduce Cardiac Troponin I After Elective Percutaneous Coronary Intervention (PCI)?

Background: Intervention of choice for reperfusion is percutaneous coronary intervention (PCI) in patients with coronary arterydisease (CAD), but it may have side effects; one of which is myocardial injury. Cardiac remote ischemic preconditioning (RIPC) canpotentially reduce these adverse effects, especially in patients with cardiovascular risk factors.Methods: This study received ethics approval on November ۲۹, ۲۰۱۷ (ethics code: HUMS.REC.۱۳۹۶.۹۳; IRCT code:IRCT۲۰۱۸۰۳۰۶۰۳۸۹۷۸N۱). It was performed on ۲۴۰ patients (۱۲۰ cases in the RIPC group and ۱۲۰ cases in the control group).The patients undergoing PCI were randomly assigned to the RIPC group (blood pressure cuff was inflated up to ۲۰۰ mmHg for ۳۰minutes on the non-dominant arm, and then deflated for ۵ minutes (reperfusion); it was repeated ۲ more times (۳ times in general)or the control group (an uninflated cuff around the non-dominant arm). Cardiac troponin I (cTnI) was compared between thehealthy controls and diabetic patients before and after PCI.Results: No significant difference was observed with regard to positive cTnI (P = ۰.۱۳۶). Positive cTnI was insignificantly higher inthe control group compared to the intervention group. However, the frequency of positive cTnI was significantly lower in diabeticpatients in the RIPC group compared to the controls (P < ۰.۰۰۱).Conclusions: This study demonstrated that RIPC is beneficial in diabetic patients and reduces the release of cTnI after elective PCIin these patients.

کلیدواژه ها:

Remote Ischemic Preconditioning ، Cardiac Troponin I ، Percutaneous Coronary Intervention ، Diabetes