Andric Veljko, Zaric Radica Zivkovic, Andric Dusan, Petrovic Jovan, Davidovic Goran
Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
Department of Internal Medicine, Health Center Raška, Raska, Serbia.
Open Med (Wars). 2025 Apr 1;20(1):20251175. doi: 10.1515/med-2025-1175. eCollection 2025.
Peripheral conditioning induces transient ischemia, promoting antioxidant production in ischemia-affected tissues, which helps reduce heart reperfusion injury in ST-elevation myocardial infarction (STEMI) patients. This study compares troponin and creatine kinase-MB (CK-MB) levels among STEMI patients with and without remote conditioning.
This study included 160 patients treated for STEMI at a tertiary care centre. The study protocol involved cyclic inflation and deflation of a blood pressure cuff on the brachial region in four cycles of 5 min each. Markers of myocardial necrosis, CK-MB, and troponin, were monitored before percutaneous coronary intervention (PCI), immediately after, and at 24, 48, and 72 h post-PCI.
CK-MB and troponin levels were significantly lower in non-diabetic patients who underwent remote peripheral conditioning compared to those who did not, with significant reductions observed after PCI (CK-MB: = 0.001; troponin: = 0.033), and at 24 (CK-MB: = 0.015; troponin: = 0.001) and 48 h post-PCI (troponin: = 0.002). In the second phase, no significant differences in CK-MB or troponin levels were found between diabetic patients with and without conditioning. However, a trend toward lower values was noted in the conditioned group. In the third phase, significant reductions in CK-MB ( = 0.002) and troponin levels (after PCI: = 0.007; 24 h post-PCI: = 0.045) were observed across all patients who underwent conditioning compared to the control group.
Peripheral pre- and post-conditioning is an economical, simple, and physiological method that effectively prevents and reduces heart damage caused by reperfusion injury, particularly in non-diabetic STEMI patients.
外周预处理可诱导短暂性缺血，促进缺血影响组织中抗氧化剂的产生，这有助于减少ST段抬高型心肌梗死（STEMI）患者的心脏再灌注损伤。本研究比较了有或没有远程预处理的STEMI患者的肌钙蛋白和肌酸激酶-MB（CK-MB）水平。
本研究纳入了一家三级医疗中心160例接受STEMI治疗的患者。研究方案包括在肱部区域对血压袖带进行四个周期、每个周期5分钟的循环充气和放气。在经皮冠状动脉介入治疗（PCI）前、术后即刻以及PCI后24、48和72小时监测心肌坏死标志物CK-MB和肌钙蛋白。
与未进行远程外周预处理的非糖尿病患者相比，进行了远程外周预处理的非糖尿病患者的CK-MB和肌钙蛋白水平显著更低，在PCI后（CK-MB：=0.001；肌钙蛋白：=0.033）以及PCI后24小时（CK-MB：=0.015；肌钙蛋白：=0.001）和48小时（肌钙蛋白：=0.002）观察到显著降低。在第二阶段，有或没有预处理的糖尿病患者的CK-MB或肌钙蛋白水平没有显著差异。然而，在预处理组中观察到值有降低的趋势。在第三阶段，与对照组相比，所有接受预处理的患者的CK-MB（=0.002）和肌钙蛋白水平（PCI后：=0.007；PCI后24小时：=0.045）均显著降低。
外周预处理和后处理是一种经济、简单且生理性的方法，可有效预防和减少再灌注损伤引起的心脏损害，尤其是在非糖尿病STEMI患者中。
