Protection of coronary circulation by remote ischemic preconditioning: An intriguing research frontier

• Main Authors: Elpidio Santillo, Raffaele Antonelli-Incalzi
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Cardiology Plus
• Subjects: Cardioprotection; cardiovascular diseases; coronary circulation; ischemic preconditioning
• Online Access: http://www.cardiologyplus.org/article.asp?issn=2470-7511;year=2018;volume=3;issue=1;spage=21;epage=29;aulast=Santillo

Ischemic preconditioning is a protective phenomenon, by which brief ischemic stimuli in a vascular bed are able to counteract the damage from a longer subsequent ischemia. Preconditioning may also confer protection from ischemia to distal tissues and organs. In this case, ischemic preconditioning is known as remote ischemic preconditioning (RIPC). RIPC can be safely and easily reproduced in clinical settings. Indeed, over the past years, its protective actions have been tested in various clinical settings, including cardiac surgery and elective percutaneous coronary interventions. However, translational studies on RIPC have provided conflicting results on reduction of mortality. Recently, studies in humans have investigated the effects of RIPC on coronary circulation, showing that RIPC could have a protective effect on coronaries. This recent area of research may offer innovative insights for designing translational studies on RIPC, unveiling new mechanisms by which RIPC protects the heart. The aims of the present manuscript are to summarize the available clinical evidence on RIPC efficacy for cardioprotection and to review studies assessing the effects of RIPC on coronary circulation in humans.