Association between Ranolazine, Ischemic Preconditioning, and Cardioprotection in Patients Undergoing Scheduled Percutaneous Coronary Intervention
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Population and Study Design
2.2. Outcomes
2.3. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Electrocardiography and Echocardiography
3.3. Medical Treatment
3.4. Hematology Markers’ Longitudinal Changes
3.5. Between-Group Differences
3.6. Multivariable Analysis
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Control Group | Preconditioning Group | Ranolazine Group | p | |
---|---|---|---|---|
(1) N = 50; 33.3% | (2) N = 50; 33.3% | (3) N = 50; 33.3% | ||
N (%) | N (%) | N (%) | ||
Gender | ||||
Men | 41 (82.0) | 39 (78.0) | 39 (78.0) | 0.850 + |
Women | 9 (18.0) | 11 (22.0) | 11 (22.0) | |
Age, mean (SD) | 65.5 (11.3) | 66.3 (9.7) | 66.3 (13.4) | 0.913 ‡ |
Heart rate, mean (SD) | 63.1 (8.5) 2 | 68.5 (9.3) 1 | 65.4 (8.0) | 0.009 ‡ |
Systolic blood pressure, mean (SD) | 135.8 (8.8) | 133.9 (12.8) | 133.6 (10.0) | 0.553 ‡ |
Diastolic blood pressure, mean (SD) | 79.2 (7.2) | 77 (9.0) | 78.1 (9.2) | 0.440 ‡ |
Nationality | ||||
Greek | 48 (96.0) | 45 (90.0) | 49 (98.0) | 0.277 ++ |
Other | 2 (4.0) | 5 (10.0) | 1 (2.0) | |
Βody mass index, mean (SD) | 28.5 (4) | 29.3 (4.1) | 29.4 (4.8) | 0.543 ‡ |
Βody mass index | ||||
Normal | 5 (10.0) | 7 (14.0) | 10 (20.0) | 0.289 + |
Overweight | 30 (60.0) | 21 (42.0) | 23 (46.0) | |
Obese | 15 (30.0) | 22 (44.0) | 17 (34.0) | |
Body surface area, mean (SD) | 2.01 (0.17) | 1.98 (0.22) | 2.02 (0.24) | 0.673 ‡ |
Smoking | ||||
No | 17 (34.0) | 16 (32.0) | 22 (44.0) | 0.052 + |
Yes, in the past | 26 (52.0) | 17 (34.0) | 14 (28.0) | |
Yes, in the present | 7 (14.0) | 17 (34.0) | 14 (28.0) | |
Packs/day, median (IQR) | 0 (0–1) | 0 (0–1) | 1 (0–1.3) | 0.424 ‡‡ |
Alcohol consumption | 2 (4.0) | 1 (2.0) | 5 (10.0) | 0.277 ++ |
Glomerular filtration rate, median (IQR) | 91.3 (79.1–124.7) | 84.8 (67.7–104.2) | 90.3 (70.3–110.5) | 0.211 ‡‡ |
Comorbidities | ||||
Hypertention | 44 (88.0) | 43 (86.0) | 44 (88.0) | 0.942 + |
Dyslipidemia | 49 (98.0) | 47 (94.0) | 43 (86.0) | 0.083 ++ |
Diabetes | 24 (48.0) | 22 (44.0) | 21 (42.0) | 0.828 + |
Coronary artery disease | 33 (67.3) | 28 (57.1) | 30 (60.0) | 0.563 + |
Atrial Fibrillation | 6 (12.0) | 5 (10.0) | 4 (8.0) | 0.801 + |
Chronic obstructive pulmonary disease | 2 (4.0) | 5 (10.0) | 7 (14.3) | 0.202 ++ |
Renal failure | 18 (36.0) | 10 (20.0) | 16 (32.0) | 0.188 + |
Peripheral vascular disease | 7 (14.0) | 3 (6.0) | 5 (10.0) | 0.411 + |
Sleep disorder | 5 (10.0) | 3 (6.0) | 6 (12.0) | 0.686 ++ |
Previous stroke/transient ischemic Attack | 0 (0.0) | 1 (2.0) | 3 (6.0) | 0.324 ++ |
Myocardial infarction | 27 (54.0) | 21 (42.0) | 24 (48.0) | 0.486 + |
Cognitive impairment | 1 (2.0) | 0 (0.0) | 0 (0.0) | 0.329 ++ |
Thyroid dysfuction | 8 (16.0) | 6 (12.0) | 5 (10.0) | 0.656 + |
Heart failure | 11 (22.4) | 14 (29.2) | 16 (32.7) | 0.521 + |
PCI characteristics * | ||||
Number of vessels | ||||
1 | 32 (66.7) | 38 (76.0) | 31 (62.0) | 0.268 + |
2 | 12 (25.0) | 12 (24.0) | 17 (34.0) | |
3 | 2 (4.2) | 0 (0.0) | 2 (4.0) | |
4 | 2 (4.2) | 0 (0.0) | 0 (0.0) | |
Number of DESs, median (IQR) | 2 (1–3) | 1 (1–2) | 1 (1–2) | 0.420 ‡ |
Medical treatment * | ||||
Acetylsalicylic acid | 50 (100.0) | 50 (100.0) | 50 (100.0) | - |
Clopidogrel | 14 (28.0) | 12 (24.5) | 17 (34.0) | 0.572 + |
Prasugrel | 19 (38.0) | 21 (42.0) | 11 (22.0) | 0.082 + |
Ticagrelor | 18 (36.0) | 17 (34.0) | 23 (46.0) | 0.418 + |
IIBIIIA during PCI | 0 (0.0) | 2 (4.1) | 0 (0.0) | 0.107 ++ |
IIBIIIA after PCI | 0 (0.0) | 4 (8.0) | 0 (0.0) | 0.034 ++ |
Coumarin anticoagulant | 2 (4.0) | 1 (2.0) | 3 (6.0) | 0.871 ++ |
Dabigatran | 1 (2.0) | 1 (2.0) | 0 (0.0) | >0.999 ++ |
Rivaroxaban | 1 (2.0) | 1 (2.0) | 0 (0.0) | >0.999 ++ |
Apixaban | 2 (4.0) | 2 (4.0) | 1 (2.0) | >0.999 ++ |
Statin | 50 (100.0) | 50 (100.0) | 46 (93.9) | 0.034 ++ |
Ezetimibe | 5 (10.0) | 5 (10.0) | 10 (20.4) | 0.216 + |
Control Group (1) | Preconditioning Group (2) | Ranolizine Group (3) | p ++ | ||||
---|---|---|---|---|---|---|---|
Mean (SD) | Median (IQR) | Mean (SD) | Median (IQR) | Mean (SD) | Median (IQR) | ||
TROPONIN I | |||||||
Before PCI | 0.04 (0) | 0.04 (0.04–0.04) | 0.04 (0) | 0.04 (0.04–0.04) | 0.04 (0) | 0.04 (0.04–0.04) | >0.999 |
4 h | 0.16 (0.29) | 0.04 (0.04–0.11) | 0.46 (1.21) | 0.05 (0.04–0.32) | 0.5 (1.93) | 0.04 (0.04–0.08) | 0.202 |
10 h | 1.91 (5.02) | 0.19 (0.07–1.13) | 1.09 (1.90) | 0.21 (0.06–1.18) | 0.74 (1.65) | 0.13 (0.06–0.42) | 0.366 |
24 h | 1. 92 (4.11) | 0.27 (0.09–2.04) | 2.55 (6.18) | 0.33 (0.06–2.1) | 0.95 (2.08) | 0.13 (0.04–0.68) | 0.159 |
p + | <0.001 | <0.001 | <0.001 |
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Kourtis, K.; Bourazana, A.; Xanthopoulos, A.; Skoularigkis, S.; Papadakis, E.; Patsilinakos, S.; Skoularigis, J. Association between Ranolazine, Ischemic Preconditioning, and Cardioprotection in Patients Undergoing Scheduled Percutaneous Coronary Intervention. Medicina 2024, 60, 166. https://doi.org/10.3390/medicina60010166
Kourtis K, Bourazana A, Xanthopoulos A, Skoularigkis S, Papadakis E, Patsilinakos S, Skoularigis J. Association between Ranolazine, Ischemic Preconditioning, and Cardioprotection in Patients Undergoing Scheduled Percutaneous Coronary Intervention. Medicina. 2024; 60(1):166. https://doi.org/10.3390/medicina60010166
Chicago/Turabian StyleKourtis, Konstantinos, Angeliki Bourazana, Andrew Xanthopoulos, Spyridon Skoularigkis, Emmanouil Papadakis, Sotirios Patsilinakos, and John Skoularigis. 2024. "Association between Ranolazine, Ischemic Preconditioning, and Cardioprotection in Patients Undergoing Scheduled Percutaneous Coronary Intervention" Medicina 60, no. 1: 166. https://doi.org/10.3390/medicina60010166