Effect of remote ischaemic conditioning on infarct size and remodelling in ST-segment elevation myocardial infarction patients: the CONDI-2/ERIC-PPCI CMR substudy

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Dokumenter

  • Fulltext

    Forlagets udgivne version, 1,02 MB, PDF-dokument

  • Rohin Francis
  • Jun Chong
  • Manish Ramlall
  • Chiara Bucciarelli-Ducci
  • Tim Clayton
  • Matthew Dodd
  • 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

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.

OriginalsprogEngelsk
Artikelnummer59
TidsskriftBasic Research in Cardiology
Vol/bind116
Udgave nummer1
ISSN0300-8428
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
The ERIC-PPCI trial was funded by a British Heart Foundation Clinical Study Grant (CS/14/3/31002) and a University College London Hospital/University College London Biomedical Research Clinical Research grant. The CONDI-2 trial was funded by Danish Innovation Foundation grants (11-108354 and 11-115818), Novo Nordisk Foundation (NNF13OC0007447), and Trygfonden (109624). DJH was supported by the British Heart Foundation (FS/10/039/28270), National Institute for Health Research University College London Hospitals Biomedical Research Centre, Duke-National University Singapore Medical School, Singapore Ministry of Health’s National Medical Research Council under its Clinician Scientist-Senior Investigator scheme (NMRC/CSA-SI/0011/2017) and its Collaborative Centre Grant scheme (NMRC/CGAug16C006). HEB was supported by the Novo Nordisk Foundation (NNF14OC0013337, NNF15OC0016674). WYK was supported by the Health Research Fund of Central Denmark Region (A1000). VMF acknowledges support from the British Heart Foundation (BHF), the BHF Centre of Research Excellence Oxford, and the NIHR Oxford BRC. TE was supported by the Novo Nordisk Foundation and the Alfred Benzon Foundation. This article is based upon the work of COST Action EU-CARDIOPROTECTION (CA16225) and supported by COST (European Cooperation in Science and Technology).

Publisher Copyright:
© 2021, The Author(s).

ID: 303577373