The RIPOST-MI study, assessing remote ischemic perconditioning alone or in combination with local ischemic postconditioning in ST-segment elevation myocardial infarction - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Basic Research in Cardiology Année : 2014

The RIPOST-MI study, assessing remote ischemic perconditioning alone or in combination with local ischemic postconditioning in ST-segment elevation myocardial infarction

Fabrice Prunier
  • Fonction : Auteur
Denis Angoulvant
Christophe Saint Etienne
  • Fonction : Auteur
Emmanuelle Vermes
  • Fonction : Auteur
Martine Gilard
  • Fonction : Auteur
Christophe Piot
  • Fonction : Auteur
François Roubille
Meyer Elbaz
  • Fonction : Auteur
Loïc Bière
  • Fonction : Auteur
Julien Jeanneteau
  • Fonction : Auteur
Stéphane Delépine
  • Fonction : Auteur
Thomas Benard
  • Fonction : Auteur
Wissam Abi-Khalil
  • Fonction : Auteur
Alain Furber

Résumé

Local ischemic postconditioning (IPost) and remote ischemic perconditioning (RIPer) are promising cardioprotective therapies in ST-elevation myocardial infarction (STEMI). We aimed: (1) to investigate whether RIPer initiated at the catheterization laboratory would reduce infarct size, as measured using serum creatine kinase-MB isoenzyme (CK-MB) release as a surrogate marker; (2) to assess if the combination of RIPer and IPost would provide an additional reduction. Patients (n = 151) were randomly allocated to one of the following groups: (1) control group, percutaneous transluminal coronary angioplasty (PTCA) alone; (2) RIPer group, PTCA combined with RIPer, consisting of three cycles of 5-min inflation and 5-min deflation of an upper-arm blood-pressure cuff initiated before reperfusion; (3) RIPer+IPost group, PTCA combined with RIPer and IPost, consisting of four cycles of 1-min inflation and 1-min deflation of the angioplasty balloon. The CK-MB area under the curve (AUC) over 72 h was reduced in RIPer, and RIPer+IPost groups, by 31 and 29 %, respectively, compared to the Control group; however, CK-MB AUC differences between the three groups were not statistically significant (p = 0.06). Peak CK-MB, CK-MB AUC to area at risk (AAR) ratio, and peak CK-MB level to AAR ratio were all significantly reduced in the RIPer and RIPer+IPost groups, compared to the Control group. On the contrary, none of these parameters was significantly different between RIPer+IPost and RIPer groups. To conclude, starting RIPer therapy immediately prior to revascularization was shown to reduce infarct size in STEMI patients, yet combining this therapy with an IPost strategy did not lead to further decrease in infarct size.
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Dates et versions

hal-01859431 , version 1 (22-08-2018)

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Fabrice Prunier, Denis Angoulvant, Christophe Saint Etienne, Emmanuelle Vermes, Martine Gilard, et al.. The RIPOST-MI study, assessing remote ischemic perconditioning alone or in combination with local ischemic postconditioning in ST-segment elevation myocardial infarction. Basic Research in Cardiology, 2014, 109 (2), ⟨10.1007/s00395-013-0400-y⟩. ⟨hal-01859431⟩
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