Effect of remote ischemic preconditioning on dynamics of troponin I content in patients with severe forms of acute coronary syndrome during coronary arteries stenting

Abstract

The aim — to study the dynamics of troponin I level when conducting remote preconditioning in patients with severe clinical forms of acute coronary syndrome during percutaneous coronary recanalization of the infarct‑related artery.Materials and methods. The study involved 58 patients with severe forms of the clinical course of acute coronary syndrome who underwent stenting of the infarct‑related coronary artery. The age of patients ranged from 65.7 to 75.0 years (mean age — 68.2 ± 4.3 years). Among them were 42 men and 16 women. The average duration of anginal status before recanalization was 138.1 ± 11.52 min. Patients were divided into two groups. In the main group (n = 30) we used the method of remote preconditioning; in the control group (n = 28) — medication and interventional treatment according to the protocols adopted by the State Institution «Institute of Нeart of Ministry of Health of Ukraine» and Clinical Hospital «Feofania». Groups were homogeneous and statistically comparable.Results and discussion. The average content of troponin I in the main group was 31.2 ± 2.4 % less than in the control group. The postoperative level of troponin I in patients of the control group with cardiogenic shock was shifted to higher values, and in the main group — to smaller ones: in the main group there were 71.43 % more individuals with troponin I level from 0.44 to 1.0 ng/ml and 66.7 % less patients with troponin I level of more than 4 ng/ml than in the control group.Conclusions. The postoperative level of troponin I in patients with cardiogenic shock in the control group was shifted to higher values, while in the main group it was shifted to smaller values: in the main group there were no cases of an increase in troponin I to more than 4 ng/ml (in the control group there were 20 % of such cases). In the control group there were no patients with the level of troponin I less than 2 ng/ml (in the main group there were 12.5 % of such patients). A statistically significant difference between groups in troponin I content was 2 — 3 ng/ml (56.25 % cases in the main group and 6.7 % in the control group).