Artigo
Remote ischemic preconditioning in myocardial protection in hemodialysis patients
Fecha
2018Registro en:
International Journal Of General Medicine. Albany, v. 11, p. 175-178, 2018.
1178-7074
WOS000431661700001.pdf
10.2147/IJGM.S144385
WOS:000431661700001
Autor
Bacci, Marcelo R.
Vasconcelos, Livia Y.
Murad, Neif
Chagas, Antonio Carlos P.
Capuano, Ana Carolina
Alves, Beatriz C. A.
Pereira, Edimar C. [UNIFESP]
Azzalis, Ligia A. [UNIFESP]
Junqueira, Virginia B. C. [UNIFESP]
Fonseca, Fernando L. A. [UNIFESP]
Institución
Resumen
Background: Remote ischemic preconditioning (RIPC) is a procedure that generates a brief period of ischemia followed by reperfusion. The role of RIPC in protecting myocardial ischemia during hemodialysis is not yet established. The aim of the study was to evaluate RIPC myocardial protection as evaluated by ultrasensitive I troponin in hemodialysis outpatients. Patients and methods: A double-blind randomized trial with two groups: intervention submitted to RIPC and control group without RIPC. Intervention group received RIPC in three consecutive hemodialysis sessions. Blood samples were taken before and after each session. Blood urea nitrogen for calculation of single-pool Kt/v and ultrasensitive I troponin were measured to evaluate dialysis adequacy and myocardial injury. Results: A total of 47 patients were randomized. About 60.8% were men and 54% were diabetic. The mean single-pool Kt/v was 1.51 in the intervention group and 1.49 in control. The ultrasensitive troponin I measured no significant change from the time of collection: before or after dialysis. Conclusion: The RIPC applied in three consecutive sessions did not demonstrate superiority to control, therefore another study tested RIPC in 12 consecutive sessions with a positive result in myocardial protection. In our study, more than half of the patients were diabetic. Diabetic patients have a trend to show a lower response to RIPC because of the greater presence of collateral coronary circulation. In summary, in this model there was no interference of RIPC in ultrasensitive troponin I values, but troponin had a high negative predictive value for myocardial infarction in all tested models.