Primary angioplasty in acutemyocardial infarction: is remote ischemic conditioning beneficial?

Abstract

Early reopening of the occluded artery paradigm has represented a milestone in the treatment of acute myocardial infarction, and its universal application in cardiological practice lead to a significant reduction in the extension of myocardial injury and mortality from this cause.
However, acute coronary occlusion is still a prevalent cause of death and disability; therefore, a lively interest in identificating new procedures, drugs or strategies that contribute to a greater preservation of myocardial tissue persists in this context.
Cardiac ischemic preconditioning in its various forms, despite having been object of several studies, both at clinical and experimental levels, is not part of the usual practice of catheterization laboratories, critical cardiology services or mobile emergency units, where myocardial reperfusion is carried out.
In this controversy, the authors present arguments for and against the use of remote cardiac ischemic preconditioning as an adjunct to primary angioplasty in a particular clinical stage, providing the reader the status of evidence about a procedure whose profit margin still awaits a clear definition.