Remote Ischemic Conditioning Did Not Improve 12 Month Clinical Outcomes After STEMI – The Cardiology Advisor

Adjunctive remote ischemic conditioning in patients undergoing treatment for ST-elevation myocardial infarction (STEMI) does not improve clinical outcomes at 12 months, according to study findings published inThe Lancet.

The investigators of the prospective, single-blind,randomized controlled trial examined whether cardioprotective remote ischemicconditioning could reduce the frequency of cardiac death and hospitalizationfor heart failure at 12 months postintervention in patients with myocardialinfarction.

The study included 5115 adults withsuspectedSTEMIfrom 33 centers across the United Kingdom, Denmark,Spain, and Serbia. All participants were eligible to undergo primarypercutaneous coronary intervention (PPCI) and were randomly assigned to receivestandard treatment (n=2569), sometimes with sham conditioning, or adjunctiveremote ischemic conditioning (n=2546) prior to PPCI.

Remote ischemic conditioning treatment involved alternatingischemia and reperfusion applied to the arm through 4 cycles of inflation (5minutes) and deflation (5 minutes) using an automated cuff device. The primaryend point was the combined frequency of cardiac death or hospitalization forheart failure at 12 months postrandomization in the intention-to-treat population.

At 12 months post-PPCI, cardiac death or hospitalization forheart failure was observed in 239 participants (9.4%) from the remote ischemicconditioning group and 220 participants (8.6%) from the control group (hazardratio, 1.10; 95% CI, 0.91-1.32;P=.32).

Analyzing individual outcomes, the investigators suggestedthat there was also no difference between control and remote ischemicconditioning groups. No major unexpected adverse events or treatment-relatedside effects were reported in either group.

A limitation of the study was the short follow-up time of 12 months, which was potentially too short to observe the effects of remote ischemic conditioning on clinical outcomes.

Based on their findings, the investigators suggest that inpatients with STEMI undergoing PPCI, adjunctive remote ischemic conditioninghas no clinically meaningful beneficial effects on outcomes of cardiac death orhospitalization for heart failure at 12 months.

Disclosure: Severalstudy authors declared affiliations with the pharmaceutical industry. Pleasesee the original reference for a full list of authors disclosures.

Reference

Hausenloy DJ, Kharbanda RK, Mller UK, et al.Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial[published online September 6, 2019].Lancet.doi:10.1016/S0140-6736(19)32039-2

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Remote Ischemic Conditioning Did Not Improve 12 Month Clinical Outcomes After STEMI - The Cardiology Advisor