Remote ischemic conditioning improves myocardial parameters and clinical outcomes during primary percutaneous coronary intervention: a meta-analysis of randomized controlled trials

Liu, Hai; Fu, Li; Sun, Xiangke; Peng, Wei; Chen, Zhiwei; Li, Yiliang

doi:10.18632/oncotarget.23818

Cited by 6 publications

(7 citation statements)

References 64 publications

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“…Looking at the current scenario, there are only a few available intervention strategies for protecting the heart and brain from ischemia-reperfusion injury due to insufficient clinical trial data and lack of pharmacokinetic and pharmacodynamic study [38]. Again, the complex sequential events leading to this condition also limit the benefits of different surgical interventions like coronary artery bypass graft surgery and percutaneous coronary intervention [39].…”

Section: Pharmacological Activitiesmentioning

confidence: 99%

Nicotinamide Mononucleotide: Exploration of Diverse Therapeutic Applications of a Potential Molecule

et al. 2019

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Nicotinamide mononucleotide (NMN) is a nucleotide that is most recognized for its role as an intermediate of nicotinamide adenine dinucleotide (NAD+) biosynthesis. Although the biosynthetic pathway of NMN varies between eukaryote and prokaryote, two pathways are mainly followed in case of eukaryotic human—one is through the salvage pathway using nicotinamide while the other follows phosphorylation of nicotinamide riboside. Due to the unavailability of a suitable transporter, NMN enters inside the mammalian cell in the form of nicotinamide riboside followed by its subsequent conversion to NMN and NAD+. This particular molecule has demonstrated several beneficial pharmacological activities in preclinical studies, which suggest its potential therapeutic use. Mostly mediated by its involvement in NAD+ biosynthesis, the pharmacological activities of NMN include its role in cellular biochemical functions, cardioprotection, diabetes, Alzheimer’s disease, and complications associated with obesity. The recent groundbreaking discovery of anti-ageing activities of this chemical moiety has added a valuable essence in the research involving this molecule. This review focuses on the biosynthesis of NMN in mammalian and prokaryotic cells and mechanism of absorption along with the reported pharmacological activities in murine model.

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Section: Pharmacological Activitiesmentioning

confidence: 99%

Nicotinamide Mononucleotide: Exploration of Diverse Therapeutic Applications of a Potential Molecule

et al. 2019

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“…A total of 1037 potential records were searched from the databases. After screening and reviewing, seven studies were included for further evaluation (Bøtker et al, 2010;Hausenloy et al, 2019;Liu et al, 2018;Munk et al, 2010;Prunier et al, 2014;Sloth et al, 2014;Yamanaka et al, 2015). These studies included a total of 2796 patients in RIC-pre group and 2818 patients in control group, as described in Fig.…”

Section: Study Characteristics and Quality Assessmentmentioning

confidence: 99%

“…Among these included studies, three were from the same clinical randomized trial (NCT00435266) with different reported endpoints (Bøtker et al, 2010;Munk et al, 2010;Sloth et al, 2017). Three studies revealed long-term clinical adverse events (Hausenloy et al, 2019;Liu et al, 2018;Sloth et al, 2014), and three studies reported short-term clinical outcomes (Bøtker et al, 2010;Hausenloy et al, 2019;Yamanaka et al, 2015). In contrast to other included RCTs, two RCTs by Yamanaka and Hausenloy were single-blinded (Hausenloy et al, 2019;Yamanaka et al, 2015), and RIC-pre protocols were performed by an automated continuous blood-pressure monitoring device.…”

Section: Study Characteristics and Quality Assessmentmentioning

confidence: 99%

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Effect of remote ischemic preconditioning in patients with STEMI during primary percutaneous coronary intervention: a meta-analysis of randomized controlled trials

Chen

Cai

et al. 2020

Reviews in Cardiovascular Medicine

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Remote ischemic conditioning is usually associated with cardioprotective intervention against ischemiareperfusion. However, the effect of remote ischemic preconditioning (RIC-pre) completed before myocardial reperfusion with intermittent limb ischemia-reperfusion in patients with STEMI undergoing primary percutaneous coronary intervention (PPCI) is unclear. PubMed, EMBASE, and the Cochrane Library were fully searched from the beginning of each database up to September 2019 to find seven RCTs, a total of 2796 patients with STEMI undergoing PPCI with RIC-pre and 2818 patients with STEMI undergoing PPCI alone. No significant discrepancy in cardiac death was observed between RIC-pre and control groups (RR 1.03, 95% CI [0.76-1.41], P = 0.83, I 2 = 40%). The incidences of hospitalization for heart failure (RR 1.03, 95% CI [0.85-1.25],P = 0.77, I 2 = 0%), myocardial infarction (RR 0.86, 95% CI [0.59-1.26], P = 0.44, I 2 = 0%), and stroke (RR 1.04, 95% CI [0.62-1.77], P = 0.87, I 2 = 0%) were not decreased in RIC-pre group when compared with control group. Subgroup analysis revealed similar risk in clinical adverse events at long-and short-term follow-up between two groups. However, peak of creatine kinase-myocardial band (CK-MB) was reduced in RIC-pre group (SWD-0.42, 95% CI [-0.77,-0.07], P = 0.02, I 2 = 34%). RIC-pre tended to a low peak of CK-MB in patients with STEMI undergoing PPCI, but lacked significant beneficial effects on improving clinical outcomes at long-and short-term follow-up.

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“…[3][4][5][6] Meta-analyses of clinical trials point towards an association between RIC and lower levels of cardiospecific biomarker release, and suggest a beneficial effect of RIC on major adverse cardiac events such as mortality, myocardial infarction (MI), and congestive heart failure (CHF) combined or separately. [7][8][9][10][11][12] A trend towards reduced clinical events at follow-up after RIC in ST-elevation myocardial infarction (STEMI) patients has been reported in two trials 13,14 while no improvement by RIC was reported in one recent large multicenter trial 15 providing additional clinical data.…”

Section: Introductionmentioning

confidence: 99%

<p>Remote Ischemic Conditioning in Patients with Acute Coronary Syndromes: A Systematic Review with Meta-Analysis and Trial Sequential Analysis</p>

Sandven¹,

Eritsland²,

Abdelnoor³

2020

CLEP

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Objective: To evaluate the efficacy of remote ischemic conditioning (RIC) as compared to no conditioning on clinical endpoints in acute coronary syndromes (ACS) patients undergoing percutaneous coronary intervention (PCI). Design: Systematic review of randomized clinical trials (RCTs). Material and Methods: Literature was searched up to September 13, 2019, and we identified a total of 13 RCTs. The efficacy of RIC on incidence of clinical events during follow-up was quantified by the rate ratio (RR) with its 95% confidence interval (CI), and we used fixed and random effects models to synthetize the results. Small-study effect was evaluated, and controlled for by the trim-and-fill method. Heterogeneity between studies was examined by subgroup and meta-regression analyses. The risk of false-positive results in meta-analysis was evaluated by trial sequential analysis (TSA).Results: Pooled analysis of 13 trials (7183 patients) showed that RIC compared to no conditioning revealed a non-significant risk reduction on endpoint mortality (RR=0.81, 95% CI: 0.56-1.17) during a median follow-up time of 1 year (range: 0.08-3.8) with low heterogeneity (I 2 =16%). Controlling for small-study effect showed no efficacy of RIC (adjusted RR: 1.03, 95% CI: 0.66-1.59). Pooled effect of RIC on the incidence of myocardial infarction (MI) from 11 trials (6996 patients) was non-significant too (RR=0.85, 95% CI: 0.62-1.18), with no observed heterogeneity (I 2 =0%) or small-study effect. A similar lack of efficacy was found in endpoint congestive heart failure (CHF) from 6 trials including 6098 patients (RR=0.71, 95% CI: 0.44-1.15), with moderate heterogeneity (I 2 =30%). TSAs showed that the pooled estimates from the cumulative meta-analyses were true negative with adequate power. Conclusion: Evidence from this updated systematic review demonstrates no beneficial effect of RIC on the incidence of clinical endpoint mortality, MI and CHF during a median follow-up of 1 year in ACS patients undergoing PCI.

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Remote ischemic conditioning improves myocardial parameters and clinical outcomes during primary percutaneous coronary intervention: a meta-analysis of randomized controlled trials

Cited by 6 publications

References 64 publications

Nicotinamide Mononucleotide: Exploration of Diverse Therapeutic Applications of a Potential Molecule

Nicotinamide Mononucleotide: Exploration of Diverse Therapeutic Applications of a Potential Molecule

Effect of remote ischemic preconditioning in patients with STEMI during primary percutaneous coronary intervention: a meta-analysis of randomized controlled trials

<p>Remote Ischemic Conditioning in Patients with Acute Coronary Syndromes: A Systematic Review with Meta-Analysis and Trial Sequential Analysis</p>

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