Renoprotective Research By Remote Ischemic Postconditioning In STEMI Patients Undergoing Percutaneous Coronary Intervention(PCI)

Objectives: The aim of the present study was to assess the efficacy of remote ischemic postconditioning(RIC) by repeated blood pressure cuff inflations in one of the upper limbs and in preventing acute kidney injury(AKI) in patients with a ST-segment elevation myocardial infarction(STEMI) undergoing PCI.Methods: 150 patients with STEMI were enrolled in our department from March to November in 2014 and the eligible patients were randomized to receive RIC by cycles of inflation and deflation of the Blood pressure cuff in one of the upper limbs immediately after the revascularization of culprit coronary artery(200mmHg lasts 10 min for 4 cycles). 137 eligible patients were included, divided randomly into RIC group(71 Patients) and control group(66 patients).The primary endpoint was AKI, and secondary endpoint was the change of eGFR. Results: 1)There were no significant difference in age, gender, blood pressure, contrast volume, baseline of serum Creatinine, BUN and e GFR before PCI et al.(P>0.05). 2)AKI rate was 9.9% in RIC group versus 31.8% in controls in three days after PCI. Patients in control group had higher risk of AKI after PCI than in RIC group(P<0.01). 3)Sharp decrease of eGFR in control group was-13.199±22.34(ml/min) versus-2.29±19.34(ml/min) in RIC group. 4)The decline of eGFR in control group was obviously greater than in RIC group(P<0.05). Conclusion: 1、The patients with STEMI undergoing PCI is easy to get AKI 2、RIC by Blood pressure cuff inflations and deflations during PCI was found to confer renoprotection in according to eGFR and reduce the risk of AKI rate in patients with STEMI undergoing PCI.