Evidence map›Paper›PMID 27884851›Full record

Trial reportBMJ open2016

Influence of preinfarction angina and coronary collateral blood flow on the efficacy of remote ischaemic conditioning in patients with ST segment elevation myocardial infarction: post hoc subgroup analysis of a randomised controlled trial.

Kasper Pryds, Morten Bøttcher, Astrid Drivsholm Sloth, Kim Munk, Michael Rahbek Schmidt, Hans Erik Bøtker, CONDI Investigators

Registry-linked trialOpen access · goldAbstract readClinical Trial, Phase IIClinical Trial, Phase IIIRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00435266 (The Effect of Remote Preconditioning in Primary Percutaneous Intervention of Acute ST Elevation Myocardial Infarction), which is not on this map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
2.7field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00435266 phase2 / phase3completednot on this map

The Effect of Remote Preconditioning in Primary Percutaneous Intervention of Acute ST Elevation Myocardial Infarction

TypeinterventionalSponsorUniversity of AarhusRan2007 to 2009Enrolled250ConditionsMyocardial InfarctionArmsRemote ischemic preconditioning
3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 31 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Kasper PrydsDepartment of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark.
Morten BøttcherDepartment of Internal Medicine, Hospital Unit West, Herning, Denmark.
Astrid Drivsholm SlothDepartment of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark.
Kim MunkDepartment of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark.
Michael Rahbek SchmidtDepartment of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark.
Hans Erik BøtkerDepartment of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark.
CONDI Investigators
Aarhus University Hospital · DKAarhus University · DKRegional Hospital West Jutland · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesRemote ischaemic conditioning (RIC) confers cardioprotection in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). We investigated whether preinfarction angina and coronary collateral blood flow (CCBF) to the infarct-related artery modify the efficacy of RIC.

designPost hoc subgroup analysis of a randomised controlled trial.

participantsA total of 139 patients with STEMI randomised to treatment with pPCI or RIC+pPCI.

interventionsRIC was performed prior to pPCI as four cycles of 5 min upper arm ischaemia and reperfusion with a blood pressure cuff. PRIMARY OUTCOME MEASURE: Myocardial salvage index (MSI) assessed by single-photon emission computerised tomography. We evaluated the efficacy of RIC in subgroups of patients with or without preinfarction angina or CCBF.

resultsOf 139 patients included in the study, 109 had available data for preinfarction angina status and 54 had preinfarction angina. Among 83 patients with Thrombolysis In Myocardial Infarction flow 0/1 on arrival, 43 had CCBF. Overall, RIC+pPCI increased median MSI compared with pPCI alone (0.75 vs 0.56, p=0.045). Mean MSI did not differ between patients with and without preinfarction angina in either the pPCI alone (0.58 and 0.57; 95% CI -0.17 to 0.19, p=0.94) or the RIC+pPCI group (0.66 and 0.69; 95% CI -0.18 to 0.10, p=0.58). Mean MSI did not differ between patients with and without CCBF in the pPCI alone group (0.51 and 0.55; 95% CI -0.20 to 0.13, p=0.64), but was increased in patients with CCBF versus without CCBF in the RIC+pPCI group (0.75 vs 0.58; 95% CI 0.03 to 0.31, p=0.02; effect modification from CCBF on the effect of RIC on MSI, p=0.06).

conclusionsPreinfarction angina did not modify the efficacy of RIC in patients with STEMI undergoing pPCI. CCBF to the infarct-related artery seems to be of importance for the cardioprotective efficacy of RIC. TRIAL REGISTRATION NUMBER: NCT00435266, Post-results.

Indexed as

AgedAngina, UnstableCollateral CirculationCoronary CirculationDenmarkFemaleHumansIschemic Preconditioning, MyocardialLinear ModelsMaleMiddle AgedMyocardial Reperfusion InjuryPercutaneous Coronary InterventionSeverity of Illness IndexST Elevation Myocardial InfarctionTomography, Emission-Computed, Single-Photon

Identifiers

PMID27884851
PMCPMC5168541
OpenAlexW2556041079

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.