Effects of Remote Ischaemic Conditioning in Stable and Unstable Angina Patients Undergoing Percutaneous Coronary...

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiovascular Research

Background:

• Type 4a myocardial infarction (T4aMI), myocardial injury post-percutaneous coronary intervention (PCI), carries a poor prognosis.
• Evidence on the efficacy of remote ischaemic conditioning (RIC) for T4aMI prevention is conflicting.
• This review focuses on RIC's effect in stable and unstable angina patients undergoing PCI.

Purpose of the Study:

• To systematically review and meta-analyze the effect of RIC on T4aMI and major adverse cardiovascular events (MACE).
• To assess RIC's impact on biochemical markers like peak troponin, CKMB, and CRP levels.
• To evaluate RIC's effectiveness specifically in patients with stable and unstable angina undergoing PCI.

Main Methods:

• Systematic review of PubMed and Central databases.
• Meta-analysis of outcomes including peak troponin, CKMB, CRP, T4aMI incidence, and MACE.
• Risk of bias assessment using the Risk of Bias 2 (RoB2) tool.

Main Results:

• Fifteen studies with low risk of bias were included.
• RIC significantly reduced T4aMI incidence (OR 0.714; p=0.026), particularly in elective PCI subgroups with high statin use.
• RIC showed a trend towards reduced peak troponin levels and significant reduction in MACE in similar subgroups.

Conclusions:

• Remote ischaemic conditioning demonstrates potential benefit in reducing peak troponin, T4aMI incidence, and MACE in patients undergoing elective PCI.
• The findings suggest RIC as a promising adjunctive therapy for myocardial protection during PCI.
• Further investigation is warranted for patients with unstable angina.