Use this URL to cite or link to this record in EThOS: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.747561
Title: Effect of remote ischaemic preconditioning in patients undergoing complex PCI : the ERIC-PCI trial
Author: Tehrani, Shaqayeq Emambakhsh
ISNI:       0000 0004 7231 4332
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2018
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Abstract:
Background- Coronary Heart Disease (CHD) is one of the leading causes of death and disability worldwide. Revascularisation of the coronary arteries using Percutaneous Coronary Intervention (PCI) has become the treatment of choice for most of the patients with CHD. Despite significant advances in angioplasty technique and introduction of anti-proliferative medications in drug eluting stents, myocardial injury during PCI is still significant. In this thesis we hypothesised whether Remote Ischaemic Preconditioning (RIPC) can reduce PCI-related myocardial injury. Methods- Eighty-eight patients awaiting elective complex PCI were randomly assigned in a 1:1 ratio to receive either the RIPC (intermittent arm ischaemia and reperfusion through four cycles of 5-minutes inflation and 5-minutes deflation of a blood-pressure cuff placed on the upper arm) or control (un-inflated cuff placed on upper-arm for 40 minutes) prior to PCI. The primary endpoint was reduction of the incidence and extent of PCI-related myocardial injury, assessed by serum cardiac biomarkers, 24 hours post PCI. Results- The Troponin T level at 24 hours post PCI was 48 ng/l in the control group vs 32.5 ng/l in the RIPC group, P = 0.39. There was no significant reduction in the total area under the curve (AUC) in the RIPC group, P= 0.43. Regarding the incidence of PCI-related myocardial injury, significant elevation of Troponin level post PCI (> 5 x baseline), was observed in 46.9% of patients in the control group and in 26.7 % of patients in the RIPC group, p =0.12. Conclusion- In the ERIC-PCI study, RIPC did not demonstrate a statistically significant attenuation of serum Troponin release post PCI. The results however showed a positive trend towards efficacy of RIPC in reducing PCI-related myocardial injury.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.747561  DOI: Not available
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