The different impact between late-phase of limb ischemia preconditioning and early-phase on patients with percutaneous coronary intervention
10.3969/j.issn.1004-8812.2017.10.005
- VernacularTitle:早期及晚期远程缺血预适应对不稳定型心绞痛经皮冠状动脉介入治疗患者的不同影响
- Author:
rong Jia LIANG
1
;
qiu Liang TANG
;
xian Yun CHEN
;
bing She ZHANG
;
mao Wen FAN
;
feng Bao CHEN
;
feng Jin CHEN
;
ying Xiang LIU
;
hui Jin HOU
Author Information
1. 粤北人民医院心血管内科
- Keywords:
Late-phase of limb ischemia preconditioning;
Early-phase of limb ischemia preconditioning;
Percutaneous coronary intervention;
cTnT;
Prognosis
- From:
Chinese Journal of Interventional Cardiology
2017;25(10):568-572
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the difference of late-phase of limb ischemia preconditioning (L-LIP) verse early-phase (E-LIP) on patients with percutaneous coronary intervention (PCI).Methods A total of 160 patients with unstable angina pectoris who were planned to undergo PCI were divided equally into two groups at random.The late-phase of limb ischemia preconditioning group (80 patients) were provided with L-LIP (three 5-minute inflations up to 200mmHg by applying the sphygmomanometer cuff around the right upper arm,followed by 5-min intervals of reperfusion,twice a day) 3 days before PCI.The Earlyphase of limb ischemia preconditioning group (80 patients) were provided with E-LIP (method as above)2 hours before PCI.Comparison of procedural parameters during PCI and the levels of cTnT,CK-MB,hs-CRP were made 24 hours after PCI.Estimation of the rate of adverse events at 1 year between the two groups was evaluated by Kaplan-Meier analysis.Results Compared to the E-LIP group,the rates of angina,arrhythmia and TIMI flow ≤ 2 during PCI were significantly lower in the L-LIP group (all P ＜ 0.05).At 24 hours after PCI,the levels of cTnT and CK-MB were declined more significantly in the L-LIP group[(11.52±2.41) pg/ml vs.(27.53±4.78)pg/ml,P =0.021;(14.11±2.87)Iu/L vs.(30.23±5.17)Iu/L,P =0.032].There was no difference in the level of hs-CRP between the 2 groups [(128±0.71)mg/dl vs.(1.33±0.69)mg/dl,P =0.742].The Kaplan-Meier survival curve showed that the incidence rate of adverse events in the L-LIP group at l year was lower than the E-LIP group (3.75％ vs.13.75％,P =0.024).Conclusions L-LIP is more effective to in protecting myocardial cell in patients with unstable angina pectoris undergoing elective PCI and may reduce the rate of future adverse event.
