Key result
Remote ischaemic conditioning significantly increased myocardial salvage index compared to controls (p<0.03), but did not affect plasma sRAGE levels in patients with STEMI.
Why the study?
Does remote ischaemic conditioning affect plasma sRAGE levels in patients with STEMI treated with primary percutaneous intervention?
RCT (n=191)
Randomized
Does remote ischaemic conditioning affect plasma sRAGE levels in patients with STEMI treated with primary percutaneous intervention?
p-value: p=<0.03
Plasma sRAGE levels do not reflect the increased myocardial salvage index observed with remote ischaemic conditioning in STEMI patients, though they correlate with worse NYHA class at 30 days.
May support remote ischaemic conditioning for myocardial salvage in STEMI; leaves open sRAGE mediation and requires randomized confirmation before practice change.
BACKGROUND: Several studies have demonstrated that soluble receptor of advanced glycation end-products (sRAGE) is a valuable inflammatory biomarker in cardiovascular disease (CVD). Remote ischaemic conditioning may rescue myocardial tissue during acute myocardial infarction (AMI). In the present study, we evaluate whether sRAGE is a helpful biomarker in patients with AMI receiving remote ischaemic conditioning. METHODS: Plasma sRAGE levels were measured in 191 patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous intervention (pPCI) of which 97 patients were randomised to receive remote ischaemic conditioning. RESULTS: The sRAGE levels were not different when compared to the randomised controls. In 122 patients, measurement of myocardial salvage index (SI) was obtained. Patients who received remote ischaemic conditioning had significantly higher SI compared to the controls (p < 0.03), although this effect was not seen in sRAGE concentrations. However, sRAGE levels increased with higher New York Heart Association (NYHA) classification after 30 days of follow-up. CONCLUSIONS: sRAGE levels do not reflect increased SI in AMI patients who received remote ischaemic conditioning prior to hospital admission.
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Jensen et al. (2015) conducted an RCT in ST-elevation myocardial infarction (STEMI) (n=191). Remote ischaemic conditioning vs. Randomised controls was evaluated on Plasma sRAGE levels and myocardial salvage index (SI) (p=<0.03). Remote ischaemic conditioning significantly increased myocardial salvage index compared to controls (p<0.03), but did not affect plasma sRAGE levels in patients with STEMI.
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