Tehrani, Shaqayeq Emambakhsh;
(2018)
Effect of remote ischaemic preconditioning in patients undergoing complex PCI: (the ERIC-PCI trial).
Doctoral thesis (M.D(Res)), UCL (University College London).
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Abstract
Background- Coronary Heart Disease (CHD) is one of the leading causes of death and disability worldwide. Revascularisation of the coronary arteries using Percutaneous Coronary Intervention (PCI) has become the treatment of choice for most of the patients with CHD. Despite significant advances in angioplasty technique and introduction of anti-proliferative medications in drug eluting stents, myocardial injury during PCI is still significant. In this thesis we hypothesised whether Remote Ischaemic Preconditioning (RIPC) can reduce PCI-related myocardial injury. Methods- Eighty-eight patients awaiting elective complex PCI were randomly assigned in a 1:1 ratio to receive either the RIPC (intermittent arm ischaemia and reperfusion through four cycles of 5-minutes inflation and 5-minutes deflation of a blood-pressure cuff placed on the upper arm) or control (un-inflated cuff placed on upper-arm for 40 minutes) prior to PCI. The primary endpoint was reduction of the incidence and extent of PCI-related myocardial injury, assessed by serum cardiac biomarkers, 24 hours post PCI. Results- The Troponin T level at 24 hours post PCI was 48 ng/l in the control group vs 32.5 ng/l in the RIPC group, P = 0.39. There was no significant reduction in the total area under the curve (AUC) in the RIPC group, P= 0.43. Regarding the incidence of PCI-related myocardial injury, significant elevation of Troponin level post PCI (> 5 x baseline), was observed in 46.9% of patients in the control group and in 26.7 % of patients in the RIPC group, p =0.12. Conclusion- In the ERIC-PCI study, RIPC did not demonstrate a statistically significant attenuation of serum Troponin release post PCI. The results however showed a positive trend towards efficacy of RIPC in reducing PCI-related myocardial injury.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | M.D(Res) |
| Title: | Effect of remote ischaemic preconditioning in patients undergoing complex PCI: (the ERIC-PCI trial) |
| Event: | UCL (University College London) |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| UCL classification: | UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10046447 |
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