IMR Press / RCM / Volume 21 / Issue 1 / DOI: 10.31083/j.rcm.2020.01.10
Open Access Systematic Review
Effect of remote ischemic preconditioning in patients with STEMI during primary percutaneous coronary intervention: a meta-analysis of randomized controlled trials
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1 Department of Cardiology, Fujian Heart Medical Center, Fujian Medical University Union Hospital, Fujian Institute of Coronary Artery Disease, Fujian Institute of Geriatrics, Fujian, 350001, P. R. China
*Correspondence: (Liang-long Chen)
Rev. Cardiovasc. Med. 2020, 21(1), 103–112;
Submitted: 2 February 2020 | Accepted: 10 March 2020 | Published: 30 March 2020
Copyright: © 2020 Chen et al. Published by IMR press.
This is an open access article under the CC BY-NC 4.0 license

Remote ischemic conditioning is usually associated with cardioprotective intervention against ischemia-reperfusion. 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, I² = 40%). The incidences of hospitalization for heart failure (RR 1.03, 95% CI [0.85-1.25], P = 0.77, I² = 0%), myocardial infarction (RR 0.86, 95% CI [0.59-1.26], P = 0.44, I² = 0%), and stroke (RR 1.04, 95% CI [0.62-1.77], P = 0.87, I² = 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, I² = 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.

ST-segment elevation myocardial infarction
remote ischemic conditioning
primary percutaneous coronary intervention
Figure 1.
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