Renoprotective effect of remote ischemic postconditioning in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Figures & data

Figure 1 Patient flow chart.

Abbreviations: eGFR, estimated glomerular filtration rate; PPCI, primary percutaneous coronary intervention; RIPostC, remote ischemic postconditioning; STEMI, ST-elevation myocardial infarction.

Table 1 Clinical characteristics of patients

Characteristics	PPCI + RIPostC	PPCI	P-value
Number of cases	29	35
Age, years	58.93±12.82	59.37±10.32	0.88
Sex
Man	24	32	0.30
Woman	5	3
Body mass index, kg/m^2	24.35±5.22	23.90±2.18	0.65
Basic diseases (n)
Hypertension	21	21	0.30
Diabetes	6	6	0.72
Dyslipidemia	6	7	0.13
Smoking	24	22	0.08
Preoperative indicators
Heart rate, number/min	77±15	79±16	0.59
Systolic pressure, mmHg	124.14±21.85	128.59±26.01	0.47
Diastolic pressure, mmHg	75.39±15.36	80.42±18.66	0.26
Serum creatinine, µmol/L	71.36±19.04	67.13±20.17	0.40
Neutrophils, 10^9/L	9.04±3.82	8.03±3.05	0.27
Platelet count, 10^9/L	219.67±47.67	205.16±60.63	0.35
LDL-C, mmol/L	2.82±0.84	3.17±1.52	0.21
TG, mmol/L	3.31±1.67	3.1±2.37	0.67
Medication (n)
Aspirin	29	35	1
Clopidogrel/ticagrelor	29	35	1
Statins	29	35	1
Beta blockers	20	35	0.94
ACEI/ARB	12	15	0.96
Ischemic time, minutes	351±132	346±141	0.90
Vascular lesions (n)
Single branch	24	32	0.45
Multibranch	5	3
Culprit vessel (n)
LAD	15	18	0.26
RCA	12	10
LCX	2	7
Killip (n)
I	28	34	0.36
II	1	0
III	0	1
Postoperative TIMI
3	24	32	0.57
2	3	2
1	2	1
0	0	0
Stent implantation (n)
Stent implanted	26	33	0.65
No stent implanted	3	2
Contrast dose, mL	88.12±23.05	91.50±20.02	0.36

Note: Values are mean ± SD.

Abbreviations: LAD, left anterior descending; LCX, left circumflex artery; RCA, right coronary artery; PPCI, primary percutaneous coronary intervention; RIPostC, remote ischemic postconditioning; TIMI, Thrombolysis in Myocardial Infarction; LDL-C, low-density lipoprotein cholesterol; TG, triglyceride; ACEI, angiotension converting enzyme inhibitors; ARB, angiotensin receptor blocker.

Figure 2 Creatine kinase-MB (CK-MB) levels.

Notes: The curve of CK-MB levels at each time point (A). The AUC of CK-MB (B).
Abbreviations: AUC, area under the curve; CK-MB, creatine kinase-MB; PPCI, primary percutaneous coronary intervention; RIPostC, remote ischemic postconditioning.

Table 2 Serum levels of CK-MB at different time points before and after PCI

CK-MB, ng/mL	PPCI + RIPostC	PPCI	P-value
Preoperative	78.74±66.21	76.15±84.19	0.87
After PCI
1/2 hour	259.53±97.44	307.58±85.50	0.04
8 hours	327.60±45.83	395.21±65.42	<0.01**
24 hours	213.42±89.39	224.21±173.29	0.76
48 hours	67.59±42.84	94.05±80.45	0.17
72 hours	32.39±17.01	48.01±37.86	0.04

Notes: Values are mean ± SD.

** P<0.01.

Abbreviations: CK-MB, creatine kinase-MB; PCI, percutaneous coronary intervention; PPCI, primary percutaneous coronary intervention; RIPostC, remote ischemic postconditioning.

Table 3 Results of renal function

AKI	PPCI + RIPostC	PPCI	P-value
Cases	3	11
Incidence, %	10.34	31.43	0.04
eGFR, mL/min/1.73 m^2
Preoperative	108.26±34.33	123.34±49.86	0.20
Postoperative	105.72±23.34	101.13±27.40	0.58
ΔeGFR	−3.43±16.29	−21.14±15.64	<0.01**

Notes: ΔeGFR, eGFR difference before and after operation. Values are mean ± SD.

** P<0.01.

Abbreviations: AKI, acute kidney injury; eGFR, estimated glomerular filtration rate; PPCI, primary percutaneous coronary intervention; RIPostC, remote ischemic postconditioning.