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dc.contributor.authorGorog, Diana
dc.contributor.authorFarag, Mohamed
dc.contributor.authorSpinthakis, Nikolaos
dc.contributor.authorYellon, Derek M.
dc.contributor.authorBøtker†, Hans E
dc.contributor.authorKharbanda, Rajesh
dc.contributor.authorHausenloy, Derek
dc.date.accessioned2020-04-17T00:08:55Z
dc.date.available2020-04-17T00:08:55Z
dc.date.issued2020-03-12
dc.identifier.citationGorog , D , Farag , M , Spinthakis , N , Yellon , D M , Bøtker† , H E , Kharbanda , R & Hausenloy , D 2020 , ' Effect of remote ischaemic conditioning on platelet reactivity and endogenous fibrinolysis in ST-elevation myocardial infarction- a substudy of the CONDI-2/ERIC4 PPCI randomised controlled trial ' , Cardiovascular Research . https://doi.org/10.1093/cvr/cvaa061
dc.identifier.issn1755-3245
dc.identifier.otherPURE: 20062927
dc.identifier.otherPURE UUID: 8cea9126-0228-4bfe-bf9a-19dc1f0034b3
dc.identifier.otherScopus: 85098703103
dc.identifier.urihttp://hdl.handle.net/2299/22599
dc.description© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited
dc.description.abstractBackground: Remote ischaemic conditioning (RIC) has been shown to reduce myocardial infarct size in animal models of myocardial infarction. Platelet thrombus formation is a critical determinant of outcome in ST-segment elevation myocardial infarction (STEMI). Whether the beneficial effects of RIC are related to thrombotic parameters is unclear. Methods and Results: In a pre-specified substudy of the Effect of Remote Ischaemic Conditioning on clinical outcomes in STEMI patients undergoing Primary Percutaneous Coronary Intervention (ERIC-PPCI) trial, we assessed the effect of RIC on thrombotic status. Patients presenting with STEMI were randomised to immediate RIC consisting of an automated autoRICTM cuff on the upper arm inflated to 200mmHg for 5 minutes and deflated for 5 minutes for 4 cycles (n=53) or sham (n=47). Venous blood was tested at presentation, discharge (48 h) and 6-8 weeks, to assess platelet reactivity, coagulation and endogenous fibrinolysis using the Global Thrombosis Test and thromboelastography (TEG). Baseline thrombotic status was similar in the 2 groups. At discharge, there was some evidence that the time to in vitro thrombotic occlusion under high shear stress was longer with RIC compared to sham (454±105s vs. 403±105s; mean difference 50.1s; 95% confidence interval [CI] 93.7- 6.4, P=0.025), but this was no longer apparent at 6-8 weeks. There was no difference in clot formation or endogenous fibrinolysis between the study arms at any time-point. Conclusion: RIC may reduce platelet reactivity in the first 48h post-STEMI. Further research is needed to delineate mechanisms through which RIC may reduce platelet reactivity, and whether it may improve outcomes in patients with persistent high on-treatment platelet reactivity.en
dc.language.isoeng
dc.relation.ispartofCardiovascular Research
dc.rightsOpen
dc.titleEffect of remote ischaemic conditioning on platelet reactivity and endogenous fibrinolysis in ST-elevation myocardial infarction- a substudy of the CONDI-2/ERIC4 PPCI randomised controlled trialen
dc.contributor.institutionDepartment of Clinical and Pharmaceutical Sciences
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionBasic and Clinical Science Unit
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionDepartment of Clinical, Pharmaceutical and Biological Science
dc.description.statusPeer reviewed
dc.relation.schoolSchool of Life and Medical Sciences
dc.description.versiontypeFinal Accepted Version
dcterms.dateAccepted2020-03-12
rioxxterms.versionAM
rioxxterms.versionofrecordhttps://doi.org/10.1093/cvr/cvaa061
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by-nc/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


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