TCT@ACC-i2: The Interventional Learning Pathway A1709 JACC April 1, 2014 Volume 63, Issue 12 A RANDOMIZED TRIAL OF REMOTE ISCHEMIC POSTCONDITIONING DURING PERCUTANEOUS CORONARY INTERVENTIONS - THE RIP-PCI TRIAL Oral Contributions Room 207 A Saturday, March 29, 2014, 9:15 a.m.-9:25 a.m. Session Title: PCI - Trials Abstract Category: 41. TCT@ACC-i2: Coronary Intervention: Devices Presentation Number: 2905-08 Authors: Shahar Lavi, Sabrina D’Alfonso, Nour Abu-Romeh, Sabrina Wall, Mistre Alemayehu, Pallav Garg, Patrick Teefy, Pantelis Diamantouros, George Jablonsky, Anthony Camuglia, Ronit Lavi, London Health Sciences Centre, London, Canada Background: Remote ischemic pre-conditioning may result in reduction in infarct size during percutaneous coronary intervention (PCI). It is unclear whether remote ischemic post-conditioning will reduce the incidence of myocardial injury following PCI, and whether a larger remote organ (thigh vs. arm), would provide further myocardial protection. Methods: We randomized 360 patients undergoing PCI, who had negative Troponin T at baseline to 3 groups: two groups received remote ischemic post-conditioning ( to either upper or lower limb) and a third, a control group. Remote ischemic postconditioning was applied during PCI immediately following stent deployment, by three 5- minute cycles of blood pressure cuff inﬂation to >200mmHg in the arm or thigh (20mmHg in the control). The primary endpoint was the proportion of patients with troponin T levels >3 x upper limit of normal (ULN) post procedure. Secondary endpoints were Troponin T (>5x ULN, periprocedural MI range), hsCRP, CK and creatinine levels. Results: Each group consisted of 120 patients. There were no differences in baseline or procedural characteristics between groups. The incidence of periprocedural myocardial injury was similar among all groups (Figure). There were no differences in CK or hsCRP levels post PCI or in the incidence of acute kidney injury between the groups. Conclusion: Remote ischemic post-conditioning during PCI, using either upper or lower limb, did not reduce the incidence of periprocedural myocardial injury.

A RANDOMIZED TRIAL OF REMOTE ISCHEMIC POSTCONDITIONING DURING PERCUTANEOUS CORONARY INTERVENTIONS – THE RIP-PCI TRIAL

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Page 1: A RANDOMIZED TRIAL OF REMOTE ISCHEMIC POSTCONDITIONING DURING PERCUTANEOUS CORONARY INTERVENTIONS – THE RIP-PCI TRIAL

TCT@ACC-i2: The Interventional Learning Pathway

A1709JACC April 1, 2014

Volume 63, Issue 12

A rAnDoMizeD triAl of reMote ischeMic PostconDitioning During PercutAneous coronAry interVentions - the riP-Pci triAl

Oral ContributionsRoom 207 ASaturday, March 29, 2014, 9:15 a.m.-9:25 a.m.

Session Title: PCI - TrialsAbstract Category: 41. TCT@ACC-i2: Coronary Intervention: DevicesPresentation Number: 2905-08

Authors: Shahar Lavi, Sabrina D’Alfonso, Nour Abu-Romeh, Sabrina Wall, Mistre Alemayehu, Pallav Garg, Patrick Teefy, Pantelis Diamantouros, George Jablonsky, Anthony Camuglia, Ronit Lavi, London Health Sciences Centre, London, Canada

background: Remote ischemic pre-conditioning may result in reduction in infarct size during percutaneous coronary intervention (PCI). It is unclear whether remote ischemic post-conditioning will reduce the incidence of myocardial injury following PCI, and whether a larger remote organ (thigh vs. arm), would provide further myocardial protection.

Methods: We randomized 360 patients undergoing PCI, who had negative Troponin T at baseline to 3 groups: two groups received remote ischemic post-conditioning ( to either upper or lower limb) and a third, a control group. Remote ischemic postconditioning was applied during PCI immediately following stent deployment, by three 5- minute cycles of blood pressure cuff inflation to >200mmHg in the arm or thigh (20mmHg in the control). The primary endpoint was the proportion of patients with troponin T levels >3 x upper limit of normal (ULN) post procedure. Secondary endpoints were Troponin T (>5x ULN, periprocedural MI range), hsCRP, CK and creatinine levels.

results: Each group consisted of 120 patients. There were no differences in baseline or procedural characteristics between groups. The incidence of periprocedural myocardial injury was similar among all groups (Figure). There were no differences in CK or hsCRP levels post PCI or in the incidence of acute kidney injury between the groups.

conclusion: Remote ischemic post-conditioning during PCI, using either upper or lower limb, did not reduce the incidence of periprocedural myocardial injury.