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The EUROpean and Chinese cardiac and renal Remote Ischemic Preconditioning Study (EURO-CRIPS): study design and
Claudio Moretti1, Erika Cavallero, Fabrizio D'Ascenzo
1aDivision of Cardiology, Città della Salute e della Scienza, University of Turin, Turin, Italy bDepartment of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy cInstitut Cardiovasculaire Paris Sud, Hôpital Jacques Cartier, Paris, France dDivision of Cardiology, Presidio Ospedaliero Misericordia, Grosseto, Italy eDivision of Cardiology, Azienda Ospedaliera Senese, Siena, Italy fDivision of Cardiology, Azienda Ospedaliera S. Luigi Gonzaga, Orbassano, Italy gDivision of Cardiology, Ospedale Maria Vittoria, Turin, Italy hDivision of Cardiology, San Giovanni Bosco Hospital, Turin, Italy iDivision of Cardiology, Istituto Clinico Humanitas, Rozzano, Milan, Italy jNanjing First Hospital, Nanjing Medical University, Nanjing, China kDivision of Cardiology, Pederzoli Hospital, Riva del Garda, Italy.
Insights
Remote ischemic preconditioning (RIPC) may reduce kidney damage and heart attacks in patients undergoing percutaneous coronary intervention (PCI). This study investigates RIPC
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Contrast-induced nephropathy (CIN) and periprocedural myocardial infarction (PMI) are common complications of percutaneous coronary intervention (PCI).
- These complications increase hospitalization duration, healthcare costs, and mid-term cardiovascular events.
- Optimizing patient outcomes following PCI is a critical clinical challenge.
Purpose of the Study:
- To evaluate the efficacy of remote ischemic preconditioning (RIPC) in reducing CIN and PMI.
- To assess the impact of RIPC on mid-term major adverse cardiac and cerebrovascular events (MACCE) after PCI.
- To provide evidence for the integration of RIPC into routine clinical practice for PCI patients.
Main Methods:
- A double-blind, randomized, placebo-controlled, multicentre study design.
- Patients aged <85 years with renal clearance of 30-60 ml/min/1.73m² undergoing PCI were randomized 1:1 to RIPC or standard therapy.
- Exclusion criteria included primary PCI for STEMI, unstable hemodynamics, or severe arrhythmias.
- Primary endpoint: incidence of CIN. Secondary endpoint: periprocedural cardiac enzyme leakage. Tertiary endpoint: MACCE at 6 months.
Main Results:
- This section is not available in the provided abstract.
- Further analysis will determine the incidence of CIN, cardiac enzyme leakage, and MACCE in RIPC versus control groups.
Conclusions:
- The EURO-CRIPS study is the first large-scale trial to investigate RIPC in current PCI practice.
- Results are anticipated to offer significant insights into optimizing PCI management strategies.
- RIPC holds potential to improve clinical outcomes for patients undergoing PCI.
Aims:
Contrast-induced nephropathy (CIN) and periprocedural myocardial infarction (PMI) represent frequent complications of percutaneous coronary intervention (PCI) and negatively impact subsequent length of hospitalization, costs of adjunctive diagnostic-therapeutic measures and mid-term cardiovascular events. The aim of the EURO-CRIPS trial is to test whether remote ischemic preconditioning (RIPC) may reduce the incidence of these complications and improve mid-term outcome.
Methods:
This will be a double-blind, randomized, placebo-controlled multicentre study. Patients will be allocated 1 : 1 to RIPC or standard therapy if they were younger than 85 years old, with a renal clearance in the interval 30-60 ml/min/1.73 m and candidate to PCI for all clinical indications except for primary PCI in ST segment elevation myocardial infarction (STEMI), unstable haemodynamic presentations or ongoing severe arrhythmias. Incidence of CIN will be the primary end point and the amount of periprocedural cardiac enzyme leakage will be the secondary end point. In addition, we will evaluate whether the preconditioned patients will have a reduction of MACCE at 6 months (major adverse cardiac and cerebrovascular event).
Conclusion:
The EURO-CRIPS Study will be the first large-scale, multicentre clinical trial to test the role of RIPC in current clinical practice. The results of this randomized trial will provide important insights to optimize management strategy of patients undergoing PCI and to improve their outcome.
