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Effect of remote ischaemic conditioning on infarct size and remodelling in ST-segment elevation myocardial infarction patients: the CONDI-2/ERIC-PPCI CMR substudy

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  • Rohin Francis, University College London
  • ,
  • Jun Chong, National University of Singapore, National Heart Centre Singapore
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  • Manish Ramlall, University College London
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  • Chiara Bucciarelli-Ducci, University Hospitals Bristol NHS Foundation Trust
  • ,
  • Tim Clayton, London School of Hygiene and Tropical Medicine
  • ,
  • Matthew Dodd, London School of Hygiene and Tropical Medicine
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  • Thomas Engstrøm, University of Copenhagen
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  • Richard Evans, London School of Hygiene and Tropical Medicine
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  • Vanessa M. Ferreira, University of Oxford, Oxford NIHR Biomedical Research Centre, Churchill Hospital, Headington, Oxford, UK., British Heart Foundation
  • ,
  • Marianna Fontana, University College London
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  • John P. Greenwood, University of Leeds, Leeds Teaching Hospitals NHS Trust
  • ,
  • Rajesh K. Kharbanda, University of Oxford
  • ,
  • Won Yong Kim
  • Tushar Kotecha, University College London
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  • Jacob T. Lønborg, University of Copenhagen
  • ,
  • Anthony Mathur, Barts Health NHS Trust, Queen Mary University of London
  • ,
  • Ulla Kristine Møller
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  • James Moon, Barts Health NHS Trust
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  • Alexander Perkins, London School of Hygiene and Tropical Medicine
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  • Roby D. Rakhit, University College London
  • ,
  • Derek M. Yellon, University College London
  • ,
  • Hans Erik Bøtker
  • Heerajnarain Bulluck, University of Leeds, Leeds Teaching Hospitals NHS Trust
  • ,
  • Derek J. Hausenloy, University College London, National University of Singapore, National Heart Centre Singapore, Asia University Taiwan

The effect of limb remote ischaemic conditioning (RIC) on myocardial infarct (MI) size and left ventricular ejection fraction (LVEF) was investigated in a pre-planned cardiovascular magnetic resonance (CMR) substudy of the CONDI-2/ERIC-PPCI trial. This single-blind multi-centre trial (7 sites in UK and Denmark) included 169 ST-segment elevation myocardial infarction (STEMI) patients who were already randomised to either control (n = 89) or limb RIC (n = 80) (4 × 5 min cycles of arm cuff inflations/deflations) prior to primary percutaneous coronary intervention. CMR was performed acutely and at 6 months. The primary endpoint was MI size on the 6 month CMR scan, expressed as median and interquartile range. In 110 patients with 6-month CMR data, limb RIC did not reduce MI size [RIC: 13.0 (5.1–17.1)% of LV mass; control: 11.1 (7.0–17.8)% of LV mass, P = 0.39], or LVEF, when compared to control. In 162 patients with acute CMR data, limb RIC had no effect on acute MI size, microvascular obstruction and LVEF when compared to control. In a subgroup of anterior STEMI patients, RIC was associated with lower incidence of microvascular obstruction and higher LVEF on the acute scan when compared with control, but this was not associated with an improvement in LVEF at 6 months. In summary, in this pre-planned CMR substudy of the CONDI-2/ERIC-PPCI trial, there was no evidence that limb RIC reduced MI size or improved LVEF at 6 months by CMR, findings which are consistent with the neutral effects of limb RIC on clinical outcomes reported in the main CONDI-2/ERIC-PPCI trial.

Original languageEnglish
Article number59
JournalBasic Research in Cardiology
Volume116
Issue1
Number of pages12
ISSN0300-8428
DOIs
Publication statusPublished - Dec 2021

    Research areas

  • Cardioprotection, Cardiovascular magnetic resonance, Myocardial infarct size, Remote ischaemic conditioning

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