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Arm Ischemia Reduces Damage After Heart Attack

Study suggests remote conditioning associated with greater salvage of heart tissue

FRIDAY, Feb. 26 (HealthDay News) -- Intermittently blocking blood flow in the arm, known as remote conditioning, during the ambulance ride to the hospital (before stenting) reduces damage to the heart after a heart attack, possibly by activating protective mechanisms in the heart, according to a study in the Feb. 27 issue of The Lancet.

Hans Erik Botker, M.D., from Aarhus University Hospital in Skejby, Denmark, and colleagues randomly assigned 333 adults with a suspected first acute ST-elevation myocardial infarction to primary percutaneous coronary intervention alone or in combination with remote conditioning (intermittent arm ischemia using a blood pressure cuff) performed during transport to the hospital.

After 30 days, the researchers found that remote conditioning was associated with significantly greater salvage of heart tissue, as determined by myocardial perfusion imaging. Remote conditioning produced even greater benefit for patients with occluded arteries on admission. Infarct size was also reduced, although this did not reach statistical significance. Both groups had similar numbers of adverse coronary events, including death, reinfarction, and heart failure.

"At a time of major difficulties in supporting the cost of our health care systems, Botker and colleagues have shown that a noninvasive, simple, safe, and cheap intervention, possibly done by a paramedic before hospital admission, can significantly increase myocardial salvage; they have also shown the benefit of an integrated prehospital and in-hospital therapeutic strategy," write the authors of an accompanying comment.

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