Meta-Analysis of Randomized Trials on Remote Ischemic Conditioning During Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction

Ischemia/ reperfusion injuryadversely affects the final infarct size (IS) after primary percutaneous coronary intervention (PCI) in patients with ST-segmentelevation myocardial infarction (STEMI). Few studies have evaluated the role of remote ischemic conditioning ( RIC) in reducing ischemia/ reperfusion injury. However, the results of these studies were not consistent, and an overview of overall effectiveness of this technique in patients with STEMI is lacking. We conducted this meta-analysis to evaluate the available evidence in literature regarding the application of RICin patients with STEMI who underwent primary PCI. The authors included randomized trials that studied RICin patients with STEMI who underwent primary PCI versus no conditioning (standard of care). Final analysis included 8 trials with a total of 1,083 patients. Compared with standard of care alone, RICwas associated with reduced IS assessed by biomarker release (standardized mean difference = −0.23, 95% confidence interval [CI] −0.37 to −0.09; p = 0.001), better rates of ST-segmentresolution (54% vs 30%; relative risk [RR] 1.78; 95% CI 1.35 to 2.34; p