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Updated: May 23, 2026
Remote Limb Ischemic Preconditioning: A Neuroprotective Technique in Rodents
Published on: June 2, 2015
Remote ischemic preconditioning immediately before percutaneous coronary intervention does not impact myocardial
Abhiram Prasad1, Mario Gössl, John Hoyt
1Division of Cardiovascular Diseases and Department of Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA. prasad.abhiram@mayo.edu
Insights
Remote ischemic preconditioning (IP) before percutaneous coronary intervention (PCI) did not reduce myocardial injury in patients with low to moderate risk. This study found no significant difference in myonecrosis rates between the IP and control groups.
Area of Science:
- Cardiology
- Interventional Cardiology
- Ischemic Heart Disease
Background:
- Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
- Myocardial injury frequently occurs during PCI, leading to adverse outcomes.
- Remote ischemic preconditioning (IP) is a potential strategy to mitigate PCI-induced myocardial injury.
Purpose of the Study:
- To investigate the efficacy of remote ischemic preconditioning (IP) in preventing myocardial injury during PCI.
- To evaluate the impact of remote IP on post-PCI myonecrosis, inflammatory markers, and endothelial progenitor cells.
Main Methods:
- A prospective clinical trial involving 95 patients undergoing non-emergency PCI.
- Patients were randomized to receive either remote IP or a sham control immediately before PCI.
- Primary endpoint: frequency of post-PCI myonecrosis (peak cTnT T ≥ 0.03 ng/dL). Secondary endpoints: changes in hsCRP and EPC counts.
Main Results:
- No significant difference in the frequency of myonecrosis between the remote IP group (47%) and the control group (40%), P = 0.42.
- No significant difference in the composite rate of death, myocardial infarction, or target lesion revascularization at 1 year (14.1% vs. 13.7%, P = 0.90).
- No significant changes observed in hsCRP levels or circulating endothelial progenitor cells (EPCs) between the groups.
Conclusions:
- Remote ischemic preconditioning (IP) administered immediately before PCI does not provide cardioprotection in patients with low to moderate risk.
- The findings suggest that remote IP is not effective in reducing myocardial injury or improving clinical outcomes in this patient population.
Aims:
Percutaneous coronary intervention (PCI) is frequently accompanied by myocardial injury. The present study was performed to determine whether remote ischemic preconditioning (IP) induces cardioprotection during PCI.
Methods:
We enrolled 95 patients requiring nonemergency PCI for stable disease or unstable angina into this prospective clinical trial. Patients were randomized to either remote IP (induced by three 3-min cycles of blood pressure cuff inflations to 200 mm Hg around the upper arm, followed by 3-min of reperfusion n = 47) or sham control (n = 48) immediately preceding PCI. The primary outcome measure was the frequency of post-PCI myonecrosis, defined as a peak postprocedural cTnT T ≥ 0.03 ng/dL. Secondary outcome measures were the change in plasma high-sensitivity C-reactive protein (hsCRP) levels following PCI and in endothelial progenitor cells (EPC) counts following IP.
Results:
There was no difference in the primary endpoint of the frequency of PCI related myonecrosis which occurred in 22 (47%) and 19 (40%) patients in the remote IP and control groups, respectively, P = 0.42. There was significant increase in hsCRP post-PCI in both groups (P < 0.001), but there was no difference between the groups (median %change in hsCRP 46% vs. 54%, P = 0.73). There was no significant change in circulating early (CD34 -/CD133+/KDR+), intermediate (CD34+/CD133+/KDR+), or late (CD34+/CD133-/KDR+) EPC in the two groups immediately following IP. The composite rate of death, myocardial infarction, and target lesion revascularization at 1 year was 14.1% versus 13.7% (P = 0.90).
Conclusions:
Our study indicates that remote IP immediately before PCI does not induce cardioprotection in low to moderate risk patients.
