Corcoran, D. et al. (2018) The effects of remote ischaemic preconditioning on coronary artery function in patients with stable coronary artery disease. International Journal of Cardiology, 252, pp. 24-30. (doi: 10.1016/j.ijcard.2017.10.082) (PMID:29249435) (PMCID:PMC5761717)
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Abstract
Background: Remote ischaemic preconditioning (RIPC) is a cardioprotective intervention invoking intermittent periods of ischaemia in a tissue or organ remote from the heart. The mechanisms of this effect are incompletely understood. We hypothesised that RIPC might enhance coronary vasodilatation by an endothelium-dependent mechanism. Methods: We performed a prospective, randomised, sham-controlled, blinded clinical trial. Patients with stable coronary artery disease (CAD) undergoing elective invasive management were prospectively enrolled, and randomised to RIPC or sham (1:1) prior to angiography. Endothelial-dependent vasodilator function was assessed in a non-target coronary artery with intracoronary infusion of incremental acetylcholine doses (10−6 , 10−5 , 10−4 mol/l). Venous blood was sampled pre- and post-RIPC or sham, and analysed for circulating markers of endothelial function. Coronary luminal diameter was assessed by quantitative coronary angiography. The primary outcome was the between-group difference in the mean percentage change in coronary luminal diameter following the maximal acetylcholine dose (Clinicaltrials.gov identifier: NCT02666235). Results: 75 patients were enrolled. Following angiography, 60 patients (mean ± SD age 57.5 ± 8.5 years; 80% male) were eligible and completed the protocol (n = 30 RIPC, n = 30 sham). The mean percentage change in coronary luminal diameter was −13.3 ± 22.3% and −2.0 ± 17.2% in the sham and RIPC groups respectively (difference 11.32%, 95%CI: 1.2– 21.4, p = 0.032). This remained significant when age and sex were included as covariates (difference 11.01%, 95%CI: 1.01– 21.0, p = 0.035). There were no between-group differences in endothelial-independent vasodilation, ECG parameters or circulating markers of endothelial function. Conclusions: RIPC attenuates the extent of vasoconstriction induced by intracoronary acetylcholine infusion. This endothelium-dependent mechanism may contribute to the cardioprotective effects of RIPC
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Berry, Professor Colin and McConnachie, Professor Alex and Collison, Dr Damien and Welsh, Professor Paul and Hennigan, Dr Barry and McCartney, Dr Peter and Oldroyd, Dr Keith and Young, Dr Robin and Corcoran, Dr David and Sattar, Professor Naveed |
| Authors: | Corcoran, D., Young, R., Cialdella, P., McCartney, P., Bajrangee, A., Hennigan, B., Collison, D., Carrick, D., Shaukat, A., Good, R., Watkins, S., McEntegart, M., Watt, J., Welsh, P., Sattar, N., McConnachie, A., Oldroyd, K.G., and Berry, C. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre |
| Journal Name: | International Journal of Cardiology |
| Publisher: | Elsevier |
| ISSN: | 0167-5273 |
| ISSN (Online): | 1874-1754 |
| Published Online: | 14 December 2017 |
| Copyright Holders: | Copyright © 2017 The Authors |
| First Published: | First published in International Journal of Cardiology 252: 24-30 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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