Table 1.
Clinical studies of ischaemic postconditioning and remote conditioning
| Reference | Population (n) | Interventions | ST-segment resolution (STR) | Enzymes | Infarct size (SPECT, MRI) | LV function (V-gram, Echo) | Other endpoints | |
|---|---|---|---|---|---|---|---|---|
| Ischaemic postconditioning | 64 | <12 h LAD, RCA, LCx (17) | 90 s R/I × 2 | Improved | → Peak CK | N/A | N/A | ↑ Coronary flow velocity |
| 65 | <6 h LAD or RCA (30) | 60 s R/I × 4 | Improved | ↓ (36%) 72 h CK | N/A | ↑ Myocardial blush grade | — | |
| 115 | <12 h LAD, RCA, LCx (94) | 30 s R/I × 3 | N/A | ↓ 72 h CK (NSD), ↓ MDA | N/A | ↑ Wall motion (8 weeks) | Improved endothelial function | |
| 73 | <12 h LAD, RCA, LCx (41) | 30 s R/I × 3 | N/A | ↓ (27%) 72 h CK | ↓ 27% (1 week) | ↑ EF (NSD) | — | |
| 69 | <6 h LAD or RCA (38) | 60 s R/I × 4 | N/A | ↓ (40%) CK, ↓ (47%) TnI | ↓ 39% (6 months) | ↑ (7%) EF (12 months) | — | |
| 67 | <6 h LAD (24) | 90 s R/I × 2 | Improved | ↓ Peak CK | N/A | → Myocardial blush grade | ↑ Coronary flow velocity | |
| 68 | <12 h LAD, RCA, LCx (75) | 30 s or 60 s R/I × 3 | N/A | N/A | N/A | N/A | ↓ Apoptosis (7 days) | |
| 74 | <12 h LAD, RCA, LCx (118) | 30 s R/I × 4 | N/A | → Peak TnT | ↓ 13% (3 months) | → EF | ↑ (31%) myocardial salvage ratio ↓ (41%) heart failure | |
| 116 | <12 h LAD or RCA (43) | 60 s R/I × 4 | Improved | ↓ CK-MB | ↓ 46% (1 week) | ↑ EF (1 week) | — | |
| 76 | <6 h LAD, RCA, LCx (76) | 60 s R/I × 4 | N/A | → TnT, → CK-MB | ↓ in patients with large AAR | N/A | — | |
| 66 | <12 h (118) | 30 s R/I × 4 | Improved | ↓ Peak TnT in patients with complete STR | ↓ in patients with complete STR (3 months) | ↑ EF in patients with complete STR (3 months) | — | |
| 117 | <12 h LAD, RCA, LCx (75) | 30 or 60 s R/I × 3 | N/A | N/A | N/A | ↑ EF (12 months), ↑ wall motion (12 months) | ↓ TNF-α (1 week) | |
| Remote ischaemic preconditioning | 118 | CABG, LAD, RCA, LCx (8) | Arm (3′–2′) × 2, 300 mmHg | N/A | ↑ LDH at 5 min after declamping | N/A | N/A | — |
| 119 | Children undergoing bypass surgery (37) | Leg (5′–5′) × 4, 15 mmHg > SBP | N/A | ↓ TnI | N/A | N/A | ↓ inotrope scores, ↓ airway resistance | |
| 120 | Elective PCI. LAD, RCA, LCx (41) | Both arms (5′–5′) × 3, 200 mmHg | N/A | ↑ CK-MB, ↑ TnI | N/A | N/A | — | |
| 101 | Elective CABG (58) | Arm (5′–5′) × 3, 200 mmHg | N/A | ↓ TnT | N/A | N/A | — | |
| 121 | Elective abdominal aortic aneurysm repair (82) | Leg (10′–10′) × 2, 200 mmHg | N/A | ↓ TnI | N/A | N/A | ↓ Incidence of MI, ↓ renal injury | |
| 100 | Elective PCI. LAD, RCA, LCx (242) | Arm (5′–5′) × 3, 200 mmHg | N/A | ↓ TnI | N/A | N/A | ↓ EKG change during stent implantation, ↓ MACCE rate at 6 months | |
| rPerC | 107,122 | <12 h LAD, RCA, LCx (251) | Arm (5′–5′) × 4, 200 mmHg or 25 mmHg > SBP | → | N/A | ↓ | → EF | May improve LV function in high-risk patients |
Population, acute ST-elevation myocardial infarction with time from the onset of chest pain in LAD, RCA (right coronary artery), and LCx (left circumflex) artery, or other diseases listed; n, the number of patients; R/I, cycle of reperfusion/ischaemia; CK, creatine kinase; Echo, echocardiogram; EF, ejection fraction; LV, left ventricular; MACCE, major adverse cardiac and cerebral events; MDA, malondialdehyde; MI, myocardial infarction; MRI, magnetic resonance imaging; SBP, systolic blood pressure; SPECT, single-photon emission computed tomography; TnI, troponin I; TnT, troponin T; V-gram, ventriculogram; →, no significant change; ↑, increase; ↓, decrease; N/A, not studied; NSD, no significant difference.