Document Detail


Frequency and clinical significance of ischemic preconditioning during percutaneous coronary intervention.
MedLine Citation:
PMID:  13678919     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to examine the short- and long-term clinical consequences of ischemic preconditioning (IP) during percutaneous coronary intervention (PCI). BACKGROUND: Ischemic preconditioning has been demonstrated in animal models to significantly diminish the extent of myocardial necrosis consequent to coronary occlusion. Surrogate markers of ischemic injury (ST segment shift, lactate release, creatine kinase release) in humans have been shown to be similarly diminished with IP elicited during PCI. There are no studies of the frequency of inducibility of IP during PCI, nor are there longer-term data on the clinical relevance of IP. METHODS: A total of 382 patients underwent elective PCI employing a previously validated protocol to elicit IP. Procedural, in-hospital, and one-year outcomes were recorded. RESULTS: Ischemic preconditioning was elicited in 80% of patients and was associated with a significant reduction in the likelihood of in-hospital adverse cardiac events (IP group, 12.1%; non-IP group, 44.1%; p < 0.0001). Women and diabetic patients were less likely to exhibit IP. By one year, patients failing to manifest IP were at significantly greater risk of post-discharge death or non-fatal myocardial infarction (MI) (non-IP group, 25.9%; IP group, 11.1%; p < 0.002). Failure to manifest IP was significantly and independently associated with an increased risk of death or non-fatal MI by one year. CONCLUSIONS: Clinically relevant short- and long-term cardioprotection can be found in association with IP during PCI. In-hospital adverse ischemic events are significantly diminished in patients with IP, as are the risks of death or non-fatal MI at one year. Failure to elicit IP during PCI serves as an independent marker of increased risk of future ischemic events.
Authors:
Warren K Laskey; Dana Beach
Related Documents :
23411709 - Differential recovery in cardiac and vasomotor sympathetic functional markers in a pati...
23173099 - The cardio-protective signaling and mechanisms of adiponectin.
23119119 - Giant left atrial myxoma causing drop attacks by prolapsing into the mitral valve.
14564299 - Inflammation as a therapeutic target: a unique role for abciximab.
21037849 - Coronary pressure measurement based decision making for percutaneous coronary intervent...
22974299 - Uncovering the molecular and cellular mechanisms of heart development using the zebrafish.
410069 - The capacity for computed tomography diagnosis of cerebral infarction. an experimental ...
8833359 - Left ventricular diastolic function in liver cirrhosis.
3675859 - Long-term intracoronary ethanol administration electrophysiologic and morphologic effects.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  42     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-18     Completed Date:  2003-11-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  998-1003     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA. warrenlaskey@earthlink.net
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary*
Female
Humans
Ischemic Preconditioning, Myocardial / statistics & numerical data*
Male
Middle Aged
Postoperative Complications / prevention & control*
Prospective Studies
Survival Rate
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2003 Sep 17;42(6):1004-6   [PMID:  13678920 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Symptom-onset-to-balloon time and mortality in patients with acute myocardial infarction treated by ...
Next Document:  Focal ischemia of the brain after neuroprotected carotid artery stenting.