Remote Ischemic Conditioning: New Approach to Preventing Myocardial Reperfusion Injury

Although reperfusion is a mainstay of therapy for myocardial infarction, reperfusion of ischemic tissue can itself cause irreversible myocardial injury. Preliminary studies have suggested that “remote ischemic conditioning” — brief periods of induced peripheral ischemia — can cause systemic metabolic changes that protect myocardium from later reperfusion injury.

Investigators in Denmark randomized 333 patients with suspected first acute MIs to receive routine percutaneous coronary intervention (PCI) either with or without remote ischemic conditioning. All patients had chest pain of <12 hours' duration and ST elevation on initial electrocardiograms. Conditioning consisted of four 10-minute cycles of inflation and deflation of a blood pressure…