Abstract
Background: Remote ischemic preconditioning (RIPC) is a simple non-invasive method by using cycles of ischemia and reperfusion on a remote organ. 
Objective: To determine the effect of RIPC outcomes in patients with ST-segment-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI).
Methods: This double blind randomized clinical trial was conducted in two teaching and reference hospitals in Mashhad, Iran. Sixty patients with acute STEMI were enrolled from October 2018 to January 2019. The patients were allocated into two groups, by using sealed envelope randomization i.e., a study group of patients who had undergone RIPC intervention and a control group of patients who had not undergone RIPC. Half an hour before PPCI, a sphygmomanometer cuff was placed around the left upper arm and inflated up to 200mmHg for five minutes; then the cuff was deflated for another five minutes, and this cycle was repeated 3 times before or during PPCI. Corrected Thrombolysis in Myocardial Infarction (TIMI) frame count, ST-segment resolution, reperfusion arrhythmias and contrast induced nephropathy (CIN) were evaluated in both groups after PPCI. Study data was analyzed by SPSS version 16.
Results: A total number of 26 males and 14 females were studied in study groups (n=20 for each). Both groups were homogenous according to their baseline characteristics. Both TIMI grade and Corrected Thrombolysis in Myocardial Infarction Frame Count CTFC significantly improved after RIPC (p=0.001 and p<0.0001 respectively). Moreover, CIN and reperfusion arrhythmias were reduced in the intervention group (p=0.028 and p=0.016 respectively). Also, ST-segment resolution was significantly different among groups (p=0.002). After adjusting for baseline factors only a significant relationship was observed between performing intervention and final TIMI grade (OR=26.416, 95% CI for OR=1.063, 656.184, p=0.046). 
Conclusion: RIPC can effectively reduce CIN and reperfusion arrhythmias in patients undergoing PPCI. Also, RIPC improved ST segment resolution and TIMI flow grade, and corrected TIMI frame count. Based on our results, RIPC may have a protective effect of on PPCI outcomes.
Trial registration: The trial was registered at the Iranian Clinical Trial Registry (IRCT) (http://www.irct.ir) with the IRCT identification number IRCT20150614022713N2.
Founding: This research was supported financially by the Research Council of Mashhad University of Medical Sciences (Ref: 970162).
 
Keywords: Ischemic Preconditioning; ST-segment Elevation Myocardial Infarction; Percutaneous Coronary Intervention; Ischemia Reperfusion Injury

 

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July-September 2019 (Volume 11, Issue 3)


 

Previous Issue

In the second issue of the journal Electronic Physician for 2019, we have several papers including four Randomized Controlled Trials, a model development study, a case report, an editorial, a letter to editor (LTE), and several original research including two studies with qualitative approach. Authors of this issue are from nine countries: Iran, The Netherlands, Sweden, Italy, India, Thailand, Saudi Arabia, United Arab Emirates (UAE), and Jordan. Read more...


 

The 6th World Conference on Research Integrity (WCRI) is to be held on June 2-5, 2019 in Hong Kong.

The WCRI is the largest and most significant international conference on research integrity. Since the first conference in Lisbon in 2007, it has given researchers, teachers, funding agencies, government officials, journal editors, senior administrators, and research students opportunities to share experiences and to discuss and promote integrity in research. Read more:


 

TDR Clinical Research and Development Fellowships

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Deadline for submission: 7 March 2019, 16:00 (GMT)

TDR provides fellowships for early- to mid-career researchers and clinical trial staff (e.g. clinicians, pharmacists, medical statisticians, data managers, other health researchers) in low- and middle-income countries (LMICs) to learn how to conduct clinical trials. Read more:


Meta-Analysis Workshops in New York, USA, and London, UK, in April and May 2019

Don't miss this exceptional opportunity to learn how to perform and report a Meta-analysis correctly. Two Meta-analysis workshops are organized in April and May 2019 by Dr. Michael Borenstein in New York, USA (April 08-10, 2019) and London, UK (May 27-29).

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Dr. Michael Borenstein, one of the authors of Introduction to Meta-Analysis, is widely recognized for his ability to make statistical concepts accessible to researchers as well as to statisticians. He has lectured widely on meta-analysis, including at the NIH, CDC, and FDA. Read more: