Startseite Impact of peripheral conditioning on reperfusion injury following primary percutaneous coronary intervention in diabetic and non-diabetic STEMI patients
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Impact of peripheral conditioning on reperfusion injury following primary percutaneous coronary intervention in diabetic and non-diabetic STEMI patients

  • Veljko Andric , Radica Zivkovic Zaric EMAIL logo , Dusan Andric , Jovan Petrovic und Goran Davidovic
Veröffentlicht/Copyright: 1. April 2025
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Open Medicine
Aus der Zeitschrift Open Medicine Band 20 Heft 1

Abstract

Background

Peripheral conditioning induces transient ischemia, promoting antioxidant production in ischemia-affected tissues, which helps reduce heart reperfusion injury in ST-elevation myocardial infarction (STEMI) patients. This study compares troponin and creatine kinase-MB (CK-MB) levels among STEMI patients with and without remote conditioning.

Methods

This study included 160 patients treated for STEMI at a tertiary care centre. The study protocol involved cyclic inflation and deflation of a blood pressure cuff on the brachial region in four cycles of 5 min each. Markers of myocardial necrosis, CK-MB, and troponin, were monitored before percutaneous coronary intervention (PCI), immediately after, and at 24, 48, and 72 h post-PCI.

Results

CK-MB and troponin levels were significantly lower in non-diabetic patients who underwent remote peripheral conditioning compared to those who did not, with significant reductions observed after PCI (CK-MB: p = 0.001; troponin: p = 0.033), and at 24 (CK-MB: p = 0.015; troponin: p = 0.001) and 48 h post-PCI (troponin: p = 0.002). In the second phase, no significant differences in CK-MB or troponin levels were found between diabetic patients with and without conditioning. However, a trend toward lower values was noted in the conditioned group. In the third phase, significant reductions in CK-MB (p = 0.002) and troponin levels (after PCI: p = 0.007; 24 h post-PCI: p = 0.045) were observed across all patients who underwent conditioning compared to the control group.

Conclusion

Peripheral pre- and post-conditioning is an economical, simple, and physiological method that effectively prevents and reduces heart damage caused by reperfusion injury, particularly in non-diabetic STEMI patients.

Keywords: reperfusion injury; STEMI; peripheral conditioning

1 Introduction

Reperfusion injury is acute tissue damage that occurs suddenly after reperfusion is established over an occluded artery that vascularized the stated tissue. The pathophysiological mechanism accompanying reperfusion injury is based on creating free radicals that overcome the body’s physiological antioxidant protection, causing oxidative stress that further damages the myocardium [1,2].

Remote peripheral conditioning is a procedure that causes transient ischemia, by interrupting the arterial blood flow on a peripheral blood vessel, on one part of the vascular bed, which results in the production of antioxidants by the ischemia-induced tissue [1]. Newly formed antioxidants are transferred through the circulation to other distant, ischemia-affected organs and tissues, where they participate and neutralize reactive oxygen groups and free radicals, thus protecting them from reperfusion injury [1,3]. The concentrations of certain antioxidants that participate in the mentioned protection are super-oxide-dismutase, glutathione peroxidase, vitamin C, and malondialdehyde, and their concentration increases after applying the peripheral conditioning protocol [2,4–6].

This study aimed to find whether artificially induced episodes of ischemia in one upper extremity can affect the reduction of reperfusion injury after percutaneous coronary intervention (PCI) in patients with ST elevation myocardial infarction (STEMI) with or without diabetes.

2 Materials and methods

This study included 160 patients treated for STEMI in the coronary care unit of a tertiary care centre. The inclusion criteria were (1) a confirmed diagnosis of acute myocardial infarction (MI) with a STEMI presentation (either first onset or recurrent STEMI), (2) PCI performed within 12 h of symptom onset, (3) administration of bisoprolol upon admission to the coronary care unit, and (4) a thrombolysis in MI flow grade of 0 or 1 in the infarct-related artery.

The exclusion criteria for this study were (1) patients without a diagnosis of STEMI or those diagnosed with STEMI but not undergoing PCI; (2) patients who exceeded the 12 h window from symptom onset to PCI; (3) presence of left bundle branch block on the initial ECG, except in cases with concordant ST elevation ≥1 mm in leads with a positive QRS complex, concordant ST depression ≥1 mm in leads V1–V3, or discordant ST elevation ≥5 mm in leads with a negative QRS complex; (4) right bundle branch block; (5) decompensated heart failure; (6) cardiogenic shock or hemodynamic instability; (7) culprit lesions in the left main coronary artery, high proximal lesions of the left anterior descending artery, or diffuse atherosclerotic disease requiring surgical intervention; (8) prior thrombolytic therapy before PCI; (9) patients with type 2 MI (due to non-atherosclerotic causes of myocardial injury), type 4a MI (periprocedural with troponin elevation >5 times baseline), or type 4b MI (stent thrombosis), as defined by the third universal definition of MI; (10) patients with a life expectancy of less than 1 year from study initiation due to comorbid conditions; (11) prior surgical resolution of ischemia; (12) pregnancy; (13) refusal to sign informed consent; (14) inability to comply with the research protocol; and (15) conditions or deformities preventing proper use of a blood pressure cuff on the upper arm.

The protocol for the study involved cyclic inflation and deflation of a blood pressure cuff placed on the brachial region, in four cycles of 5 min each (5 min of inflation followed by 5 min of deflation). During inflation, the cuff pressure was set to 20 mmHg above the patient’s systolic blood pressure. The deflation procedure involved completely releasing the cuff pressure to a value below the diastolic blood pressure. This protocol was conducted before coronary angiography and PCI (pre-conditioning) and immediately following the PCI procedure (post-conditioning).

The patients were divided into four groups 40 patients each: Group I included patients with STEMI without type 2 diabetes; Group II included STEMI patients with type 2 diabetes; Group III included STEMI patients who underwent remote pre- and post-conditioning but did not have type 2 diabetes; and Group IV included STEMI patients who underwent remote pre- and post-conditioning and had type 2 diabetes.

In these patients, we monitored creatine kinase-MB (CK-MB) and troponin as markers of myocardial necrosis and reperfusion injury size before the PCI procedure, immediately after the PCI procedure, and at 24, 48, and 72 h post-PCI.

We analysed the data by parametric or nonparametric methods. Observed characteristics were expressed as mean values, standard deviation, median, and interquartile range. The Mann–Whitney U-test and Wilcoxon signed-rank test were used for continuous nonparametric data, and continuous parametric data were analysed using Student’s t-test and paired t-test. To assess the strength of the relationship between continuous variables, correlation and regression analyses were performed. Categorical data were analysed using the Chi-square test and Fisher exact test, to determine the statistically significant difference. Significance was set at a two-sided p < 0.05. IBM SPSS Statistics 26 (Armonk, New York, USA) was used for the analysis.

  1. Ethical approval: The research has been approved by the ethical University Clinical Center Kragujevac; 30.01.2018; No 01/18-455.

3 Results

Demographic and clinical data are given in Table 1. In all four groups, males were the predominant sex. As for the age groups the largest number of patients, 90 (56.3%) were aged 41–64, 62 patients (38.8%) belonged to the age group over 65, and 8 patients (5%) were under 40 years old. When it comes to age distribution by group, in all four investigated groups we had the largest number of respondents aged 41–64. We did not find a significant difference in examined parameters between the comparison groups, except in the presence of dyslipidaemia (p = 0.005).

Table 1

Demographic and clinical characteristics of patients

Factor Total Group I Group II Group III Group IV p
N = 160 N = 40 N = 40 N = 40 N = 40
Male sex 111 (69.4) 28 (70) 30 (75) 31 (77.5) 22 (55) 0.125
Age (>65 years) 62 (38.8) 12 (30) 15 (37.5) 19 (47.5) 16 (40) 0.452
Dyslipidemia 57 (35.6) 10 (25) 21 (52.5) 8 (20) 18 (45) 0.005
Smoking 71 (44.4) 19 (47.5) 17 (42.5) 18 (45) 17 (42.5) 0.964

Data are given as n (%).

Based on the localization of STEMI, the patients were categorized into four groups: anterior, anterior-extended, inferior, and posterior-inferior. Among the entire cohort, the most prevalent type was inferior MI, observed in 67 patients (41.9%). This was followed by anterior-extended infarction in 45 patients (28.1%), posterior-inferior in 28 patients (17.5%), and anterior infarction in 20 patients (12.5%). When comparing the prevalence of inferior infarction across the groups, a slightly higher, but not statistically significant, prevalence of inferior localization was noted compared to the other three groups (p = 0.856).

In the first phase of the study, we compared CK-MB and troponin values between a control group of non-diabetics, non-conditioned patients and a conditioned group of non-diabetic patients who underwent remote peripheral conditioning according to the previously described protocol. Each group consisted of 40 patients. Monitoring CK-MB values at various time intervals revealed a statistically significant decrease in CK-MB levels in the conditioned group after PCI (p = 0.001) and 24 h post-PCI (p = 0.015), while no significant differences were observed at other time points (Table 2). Similarly, a significant reduction in troponin levels was observed after PCI (p = 0.033), 24 h post-PCI (p = 0.001), and 48 h post-PCI (p = 0.002) in the conditioned group, indicating a beneficial effect of remote peripheral conditioning (Table 2, Figure 1).

Table 2

Values of CK-MB and troponin in control and conditioned groups of patients without diabetes

CK-MB Troponin
Conditioning (IU/L) Control (IU/L) p Conditioning (ng/mL) Control (ng/mL) p
Before PCI 99.30 ± 152.62 51.95 ± 70.41 0.079 3.82 ± 9.13 1.69 ± 4.24 0.184
After PCI 79.18 ± 126.00 187.60 ± 162.25 0.001 10.77 ± 18.56 22.05 ± 27.02 0.033
24 h after PCI 49.60 ± 121.39 117.10 ± 121.64 0.015 4.84 ± 7.07 15.00 ± 16.31 0.001
48 h after PCI 37.83 ± 78.76 67.70 ± 71.69 0.080 3.41 ± 5.09 9.55 ± 10.94 0.002
72 h after PCI 29.73 ± 62.91 44.43 ± 58.34 0.282 — — —

CK-MB: creatine kinase-MB; PCI: percutaneous coronary intervention.

Figure 1 Baseline comparison charts: (a) patients without diabetes mellitus, (b) patients with diabetes mellitus, and (c) CK-MB and troponin values across the control and conditioned groups, regardless of diabetes status.
Figure 1

Baseline comparison charts: (a) patients without diabetes mellitus, (b) patients with diabetes mellitus, and (c) CK-MB and troponin values across the control and conditioned groups, regardless of diabetes status.

In the second phase, we compared these parameters between two additional groups of 40 patients each: the control group, consisting of diabetic patients without conditioning, and the conditioned group, consisting of diabetic patients who underwent conditioning. Although no statistically significant differences were observed in CK-MB or troponin levels between the two groups, a downward trend in these markers was noted in the conditioned group compared to the control group (Table 3).

Table 3

Values of CK-MB and troponin in control and conditioned groups of patients with diabetes

CK-MB Troponin
Conditioning (IU/L) Control (IU/L) p Conditioning (ng/mL) Control (ng/mL) p
Before PCI 37.55 ± 42.78 64.18 ± 74.74 0.054 10.11 ± 28.76 11.38 ± 40.52 0.872
After PCI 97.48 ± 113.42 122.68 ± 116.34 0.330 8.77 ± 9.41 18.82 ± 35.25 0.085
24 h after PCI 87.35 ± 111.84 73.78 ± 67.02 0.512 10.76 ± 13.45 8.56 ± 9.87 0.409
48 h after PCI 60.05 ± 71.26 44.13 ± 32.54 0.202 7.23 ± 10.20 4.80 ± 7.35 0.226
72 h after PCI 27.63 ± 31.34 25.18 ± 27.79 0.712 — — —

CK-MB: creatine kinase-MB; PCI: percutaneous coronary intervention.

In the third phase, we analysed the CK-MB and troponin values across the control and conditioned groups, regardless of diabetes status. Each group included 80 patients. Statistically significant differences were observed in CK-MB levels after PCI (p = 0.002), as well as troponin levels after PCI (p = 0.007) and 24 h post-PCI (p = 0.045). A reduction in the levels of these laboratory markers was again noted following remote peripheral conditioning in the conditioned group compared to the control group.

4 Discussion

In this study, we observed a significant reduction in CK-MB levels in patients who received pre- and post-conditioning compared to those who did not, immediately after PCI and 24 h post-PCI. No statistically significant differences were found before PCI or at 48 and 72 h post-PCI. A similar pattern was observed with troponin values, which showed significant reductions immediately after PCI, as well as at 24 and 48 h, compared to the control group. Previous research has demonstrated the protective effect of post-conditioning in STEMI patients following angioplasty [7], and this study supports these findings by showing that remote pre- and post-conditioning significantly reduces reperfusion injury after PCI [8]. Other studies have also confirmed the protective effects of peripheral conditioning across various organs, including the brain [9], kidneys [10–12], lungs [13,14], liver [15,16], and skin [4,11].

Systematic review from 2015 also demonstrated the effects of remote ischemic conditioning on cardioprotection among many included studies and it was proven that it significantly decreased troponin and CK MB in blood of patients [17].

Predomination of male gender is in correlation with many other studies in patients with PCI [18]. It was most often in patients younger than 65 years, probably because they see a cardiologist earlier. About half of the patients were smokers which is also in correlation with other studies [19].

Cardiac marker values did not show significant differences between the groups before the conditioning protocol, which is expected given the homogeneity of the study groups concerning factors influencing cardiac marker levels. Statistically significant differences in CK-MB values were noted immediately after post-conditioning and 24 h post-PCI, but not at 48 and 72 h. This timing aligns with the known kinetics of CK-MB concentration, where the conditioning effect is most pronounced during the rising phase and peak concentration period. By 72 h, as CK-MB levels decline, the impact of conditioning is less apparent. Troponin I value showed a similar trend, with significant differences observed immediately after PCI, 24, and 48 h post-PCI. The troponin I value normalizes later than CK-MB, which explains the observed differences between the two markers at 48 h. The second phase of peripheral conditioning effects typically occurs between 12 and 24 h, further supporting the timing of our results.

For diabetic patients, no statistically significant differences in CK-MB and troponin I were found between conditioned and control groups. These findings are consistent with other studies on post-conditioning in both animal models and humans [20,21].

5 Conclusion

Peripheral pre- and post-conditioning is an effective, economical, simple, and safe method for preventing and reducing myocardial damage caused by reperfusion injury. This approach can be considered a viable therapeutic option for treating STEMI in non-diabetic patients. However, in diabetic patients with STEMI, the protocol did not show a significant impact on the size of reperfusion injury. Therefore, there is currently no compelling evidence to support its routine use in this population.

  1. Funding information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

  2. Author contributions: V.A. and G.D.: conceptualization, methodology; D.A., V.A., and R.Z.Z.: data curation, writing – original draft preparation; D.A.: visualization, investigation; G.D. and R.Z.Z.: supervision; J.P.: software, validation; J.P.: writing – reviewing and editing.

  3. Conflict of interest: All authors declare no conflict of interest.

  4. Data availability statement: Data supporting the findings are available from the corresponding author (JP) upon a reasonable request.

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Received: 2024-10-31
Revised: 2025-01-28
Accepted: 2025-03-09
Published Online: 2025-04-01

© 2025 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  88. Comparison of computed tomography and guided bronchoscopy in the diagnosis of pulmonary nodules: A systematic review and meta-analysis
  89. Curdione protects vascular endothelial cells and atherosclerosis via the regulation of DNMT1-mediated ERBB4 promoter methylation
  90. The identification of novel missense variant in ChAT gene in a patient with gestational diabetes denotes plausible genetic association
  91. Molecular genotyping of multi-system rare blood types in foreign blood donors based on DNA sequencing and its clinical significance
  92. Exploring the role of succinyl carnitine in the association between CD39⁺ CD4⁺ T cell and ulcerative colitis: A Mendelian randomization study
  93. Dexmedetomidine suppresses microglial activation in postoperative cognitive dysfunction via the mmu-miRNA-125/TRAF6 signaling axis
  94. Analysis of serum metabolomics in patients with different types of chronic heart failure
  95. Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
  96. Pachymaran alleviates fat accumulation, hepatocyte degeneration, and injury in mice with nonalcoholic fatty liver disease
  97. Decrease in CD4 and CD8 lymphocytes are predictors of severe clinical picture and unfavorable outcome of the disease in patients with COVID-19
  98. METTL3 blocked the progression of diabetic retinopathy through m6A-modified SOX2
  99. The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors
  100. Exploring cerebrospinal fluid metabolites, cognitive function, and brain atrophy: Insights from Mendelian randomization
  101. Development and validation of potential molecular subtypes and signatures of ocular sarcoidosis based on autophagy-related gene analysis
  102. Widespread venous thrombosis: Unveiling a complex case of Behçet’s disease with a literature perspective
  103. Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
  104. Discovery of lipid metabolism-related diagnostic biomarkers and construction of diagnostic model in steroid-induced osteonecrosis of femoral head
  105. Serum-derived exomiR-188-3p is a promising novel biomarker for early-stage ovarian cancer
  106. Enhancing chronic back pain management: A comparative study of ultrasound–MRI fusion guidance for paravertebral nerve block
  107. Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
  108. Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
  109. Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
  110. Cell-free adipose extract inhibits hypertrophic scar formation through collagen remodeling and antiangiogenesis
  111. HALP score in Demodex blepharitis: A case–control study
  112. Assessment of SOX2 performance as a marker for circulating cancer stem-like cells (CCSCs) identification in advanced breast cancer patients using CytoTrack system
  113. Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
  114. Comparison of the two intestinal anastomosis methods in pediatric patients
  115. Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
  116. Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
  117. Lateral transperitoneal laparoscopic adrenalectomy: A single-centre experience of 21 procedures
  118. Petunidin attenuates lipopolysaccharide-induced retinal microglia inflammatory response in diabetic retinopathy by targeting OGT/NF-κB/LCN2 axis
  119. Procalcitonin and C-reactive protein as biomarkers for diagnosing and assessing the severity of acute cholecystitis
  120. Factors determining the number of sessions in successful extracorporeal shock wave lithotripsy patients
  121. Development of a nomogram for predicting cancer-specific survival in patients with renal pelvic cancer following surgery
  122. Inhibition of ATG7 promotes orthodontic tooth movement by regulating the RANKL/OPG ratio under compression force
  123. A machine learning-based prognostic model integrating mRNA stemness index, hypoxia, and glycolysis‑related biomarkers for colorectal cancer
  124. Glutathione attenuates sepsis-associated encephalopathy via dual modulation of NF-κB and PKA/CREB pathways
  125. FAHD1 prevents neuronal ferroptosis by modulating R-loop and the cGAS–STING pathway
  126. Association of placenta weight and morphology with term low birth weight: A case–control study
  127. Review Articles
  128. The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
  129. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  130. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  131. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  132. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  133. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  134. The application of augmented reality in robotic general surgery: A mini-review
  135. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  136. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  137. Plant polyphenols, terpenes, and terpenoids in oral health
  138. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  139. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  140. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  141. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  142. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
  143. Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
  144. Giant borderline ovarian tumours – review of the literature
  145. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
  146. Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
  147. Risk factors of frailty/sarcopenia in community older adults: Meta-analysis
  148. Supplement strategies for infertility in overweight women: Evidence and legal insights
  149. Scurvy, a not obsolete disorder: Clinical report in eight young children and literature review
  150. Case Reports
  151. Delayed graft function after renal transplantation
  152. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
  153. Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
  154. Giant right atrial hemangioma presenting with ascites: A case report
  155. Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
  156. EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation
  157. Rapid Communication
  158. Biological properties of valve materials using RGD and EC
  159. Letter to the Editor
  160. Role of enhanced external counterpulsation in long COVID
  161. Expression of Concern
  162. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  163. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  164. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  165. Corrigendum
  166. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  167. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  168. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  169. Retraction
  170. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  171. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
  172. Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
  173. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
  174. The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
  175. Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
  176. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  177. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  178. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  179. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  180. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  181. The mRNA MOXD1: Link to oxidative stress and prognostic significance in gastric cancer
  182. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  183. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  184. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  185. Special Issue Diabetes
  186. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  187. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  188. A discussion on the application of fluorescence micro-optical sectioning tomography in the research of cognitive dysfunction in diabetes
  189. A review of brain research on T2DM-related cognitive dysfunction
  190. Special Issue Biomarker Discovery and Precision Medicine
  191. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
https://doi.org/10.1515/med-2025-1175
Schlagwörter für diesen Artikel
reperfusion injury; STEMI; peripheral conditioning
Creative Commons
BY 4.0

Artikel in diesem Heft

  1. Research Articles
  2. Network pharmacological analysis and in vitro testing of the rutin effects on triple-negative breast cancer
  3. Impact of diabetes on long-term survival in elderly liver cancer patients: A retrospective study
  4. Knockdown of CCNB1 alleviates high glucose-triggered trophoblast dysfunction during gestational diabetes via Wnt/β-catenin signaling pathway
  5. Risk factors for severe adverse drug reactions in hospitalized patients
  6. Analysis of the effect of ALA-PDT on macrophages in footpad model of mice infected with Fonsecaea monophora based on single-cell sequencing
  7. Development and validation of headspace gas chromatography with a flame ionization detector method for the determination of ethanol in the vitreous humor
  8. CMSP exerts anti-tumor effects on small cell lung cancer cells by inducing mitochondrial dysfunction and ferroptosis
  9. Predictive value of plasma sB7-H3 and YKL-40 in pediatric refractory Mycoplasma pneumoniae pneumonia
  10. Antiangiogenic potential of Elaeagnus umbellata extracts and molecular docking study by targeting VEGFR-2 pathway
  11. Comparison of the effectiveness of nurse-led preoperative counseling and postoperative follow-up care vs standard care for patients with gastric cancer
  12. Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis
  13. Adhered macrophages as an additional marker of cardiomyocyte injury in biopsies of patients with dilated cardiomyopathy
  14. Association between statin administration and outcome in patients with sepsis: A retrospective study
  15. Exploration of the association between estimated glucose disposal rate and osteoarthritis in middle-aged and older adults: An analysis of NHANES data from 2011 to 2018
  16. A comparative analysis of the binary and multiclass classified chest X-ray images of pneumonia and COVID-19 with ML and DL models
  17. Lysophosphatidic acid 2 alleviates deep vein thrombosis via protective endothelial barrier function
  18. Transcription factor A, mitochondrial promotes lymph node metastasis and lymphangiogenesis in epithelial ovarian carcinoma
  19. Serum PM20D1 levels are associated with nutritional status and inflammatory factors in gastric cancer patients undergoing early enteral nutrition
  20. Hydromorphone reduced the incidence of emergence agitation after adenotonsillectomy in children with obstructive sleep apnea: A randomized, double-blind study
  21. Vitamin D replacement therapy may regulate sleep habits in patients with restless leg syndrome
  22. The first-line antihypertensive nitrendipine potentiated the therapeutic effect of oxaliplatin by downregulating CACNA1D in colorectal cancer
  23. Health literacy and health-related quality of life: The mediating role of irrational happiness
  24. Modulatory effects of Lycium barbarum polysaccharide on bone cell dynamics in osteoporosis
  25. Mechanism research on inhibition of gastric cancer in vitro by the extract of Pinellia ternata based on network pharmacology and cellular metabolomics
  26. Examination of the causal role of immune cells in non-alcoholic fatty liver disease by a bidirectional Mendelian randomization study
  27. Clinical analysis of ten cases of HIV infection combined with acute leukemia
  28. Investigating the cardioprotective potential of quercetin against tacrolimus-induced cardiotoxicity in Wistar rats: A mechanistic insights
  29. Clinical observation of probiotics combined with mesalazine and Yiyi Baitouweng Decoction retention enema in treating mild-to-moderate ulcerative colitis
  30. Diagnostic value of ratio of blood inflammation to coagulation markers in periprosthetic joint infection
  31. Sex-specific associations of sex hormone binding globulin and risk of bladder cancer
  32. Core muscle strength and stability-oriented breathing training reduces inter-recti distance in postpartum women
  33. The ERAS nursing care strategy for patients undergoing transsphenoidal endoscopic pituitary tumor resection: A randomized blinded controlled trial
  34. The serum IL-17A levels in patients with traumatic bowel rupture post-surgery and its predictive value for patient prognosis
  35. Impact of Kolb’s experiential learning theory-based nursing on caregiver burden and psychological state of caregivers of dementia patients
  36. Analysis of serum NLR combined with intraoperative margin condition to predict the prognosis of cervical HSIL patients undergoing LEEP surgery
  37. Commiphora gileadensis ameliorate infertility and erectile dysfunction in diabetic male mice
  38. The correlation between epithelial–mesenchymal transition classification and MMP2 expression of circulating tumor cells and prognosis of advanced or metastatic nasopharyngeal carcinoma
  39. Tetrahydropalmatine improves mitochondrial function in vascular smooth muscle cells of atherosclerosis in vitro by inhibiting Ras homolog gene family A/Rho-associated protein kinase-1 signaling pathway
  40. A cross-sectional study: Relationship between serum oxidative stress levels and arteriovenous fistula maturation in maintenance dialysis patients
  41. A comparative analysis of the impact of repeated administration of flavan 3-ol on brown, subcutaneous, and visceral adipose tissue
  42. Identifying early screening factors for depression in middle-aged and older adults: A cohort study
  43. Perform tumor-specific survival analysis for Merkel cell carcinoma patients undergoing surgical resection based on the SEER database by constructing a nomogram chart
  44. Unveiling the role of CXCL10 in pancreatic cancer progression: A novel prognostic indicator
  45. High-dose preoperative intraperitoneal erythropoietin and intravenous methylprednisolone in acute traumatic spinal cord injuries following decompression surgeries
  46. RAB39B: A novel biomarker for acute myeloid leukemia identified via multi-omics and functional validation
  47. Impact of peripheral conditioning on reperfusion injury following primary percutaneous coronary intervention in diabetic and non-diabetic STEMI patients
  48. Clinical efficacy of azacitidine in the treatment of middle- and high-risk myelodysplastic syndrome in middle-aged and elderly patients: A retrospective study
  49. The effect of ambulatory blood pressure load on mitral regurgitation in continuous ambulatory peritoneal dialysis patients
  50. Expression and clinical significance of ITGA3 in breast cancer
  51. Single-nucleus RNA sequencing reveals ARHGAP28 expression of podocytes as a biomarker in human diabetic nephropathy
  52. rSIG combined with NLR in the prognostic assessment of patients with multiple injuries
  53. Toxic metals and metalloids in collagen supplements of fish and jellyfish origin: Risk assessment for daily intake
  54. Exploring causal relationship between 41 inflammatory cytokines and marginal zone lymphoma: A bidirectional Mendelian randomization study
  55. Gender beliefs and legitimization of dating violence in adolescents
  56. Effect of serum IL-6, CRP, and MMP-9 levels on the efficacy of modified preperitoneal Kugel repair in patients with inguinal hernia
  57. Effect of smoking and smoking cessation on hematological parameters in polycythemic patients
  58. Pathogen surveillance and risk factors for pulmonary infection in patients with lung cancer: A retrospective single-center study
  59. Necroptosis of hippocampal neurons in paclitaxel chemotherapy-induced cognitive impairment mediates microglial activation via TLR4/MyD88 signaling pathway
  60. Celastrol suppresses neovascularization in rat aortic vascular endothelial cells stimulated by inflammatory tenocytes via modulating the NLRP3 pathway
  61. Cord-lamina angle and foraminal diameter as key predictors of C5 palsy after anterior cervical decompression and fusion surgery
  62. GATA1: A key biomarker for predicting the prognosis of patients with diffuse large B-cell lymphoma
  63. Influencing factors of false lumen thrombosis in type B aortic dissection: A single-center retrospective study
  64. MZB1 regulates the immune microenvironment and inhibits ovarian cancer cell migration
  65. Integrating experimental and network pharmacology to explore the pharmacological mechanisms of Dioscin against glioblastoma
  66. Trends in research on preterm birth in twin pregnancy based on bibliometrics
  67. Four-week IgE/baseline IgE ratio combined with tryptase predicts clinical outcome in omalizumab-treated children with moderate-to-severe asthma
  68. Single-cell transcriptomic analysis identifies a stress response Schwann cell subtype
  69. Acute pancreatitis risk in the diagnosis and management of inflammatory bowel disease: A critical focus
  70. Effect of subclinical esketamine on NLRP3 and cognitive dysfunction in elderly ischemic stroke patients
  71. Interleukin-37 mediates the anti-oral tumor activity in oral cancer through STAT3
  72. CA199 and CEA expression levels, and minimally invasive postoperative prognosis analysis in esophageal squamous carcinoma patients
  73. Efficacy of a novel drainage catheter in the treatment of CSF leak after posterior spine surgery: A retrospective cohort study
  74. Comprehensive biomedicine assessment of Apteranthes tuberculata extracts: Phytochemical analysis and multifaceted pharmacological evaluation in animal models
  75. Relation of time in range to severity of coronary artery disease in patients with type 2 diabetes: A cross-sectional study
  76. Dopamine attenuates ethanol-induced neuronal apoptosis by stimulating electrical activity in the developing rat retina
  77. Correlation between albumin levels during the third trimester and the risk of postpartum levator ani muscle rupture
  78. Factors associated with maternal attention and distraction during breastfeeding and childcare: A cross-sectional study in the west of Iran
  79. Mechanisms of hesperetin in treating metabolic dysfunction-associated steatosis liver disease via network pharmacology and in vitro experiments
  80. The law on oncological oblivion in the Italian and European context: How to best uphold the cancer patients’ rights to privacy and self-determination?
  81. The prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and prognostic nutritional index for survival in patients with colorectal cancer
  82. Factors affecting the measurements of peripheral oxygen saturation values in healthy young adults
  83. Comparison and correlations between findings of hysteroscopy and vaginal color Doppler ultrasonography for detection of uterine abnormalities in patients with recurrent implantation failure
  84. The effects of different types of RAGT on balance function in stroke patients with low levels of independent walking in a convalescent rehabilitation hospital
  85. Causal relationship between asthma and ankylosing spondylitis: A bidirectional two-sample univariable and multivariable Mendelian randomization study
  86. Correlations of health literacy with individuals’ understanding and use of medications in Southern Taiwan
  87. Correlation of serum calprotectin with outcome of acute cerebral infarction
  88. Comparison of computed tomography and guided bronchoscopy in the diagnosis of pulmonary nodules: A systematic review and meta-analysis
  89. Curdione protects vascular endothelial cells and atherosclerosis via the regulation of DNMT1-mediated ERBB4 promoter methylation
  90. The identification of novel missense variant in ChAT gene in a patient with gestational diabetes denotes plausible genetic association
  91. Molecular genotyping of multi-system rare blood types in foreign blood donors based on DNA sequencing and its clinical significance
  92. Exploring the role of succinyl carnitine in the association between CD39⁺ CD4⁺ T cell and ulcerative colitis: A Mendelian randomization study
  93. Dexmedetomidine suppresses microglial activation in postoperative cognitive dysfunction via the mmu-miRNA-125/TRAF6 signaling axis
  94. Analysis of serum metabolomics in patients with different types of chronic heart failure
  95. Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
  96. Pachymaran alleviates fat accumulation, hepatocyte degeneration, and injury in mice with nonalcoholic fatty liver disease
  97. Decrease in CD4 and CD8 lymphocytes are predictors of severe clinical picture and unfavorable outcome of the disease in patients with COVID-19
  98. METTL3 blocked the progression of diabetic retinopathy through m6A-modified SOX2
  99. The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors
  100. Exploring cerebrospinal fluid metabolites, cognitive function, and brain atrophy: Insights from Mendelian randomization
  101. Development and validation of potential molecular subtypes and signatures of ocular sarcoidosis based on autophagy-related gene analysis
  102. Widespread venous thrombosis: Unveiling a complex case of Behçet’s disease with a literature perspective
  103. Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
  104. Discovery of lipid metabolism-related diagnostic biomarkers and construction of diagnostic model in steroid-induced osteonecrosis of femoral head
  105. Serum-derived exomiR-188-3p is a promising novel biomarker for early-stage ovarian cancer
  106. Enhancing chronic back pain management: A comparative study of ultrasound–MRI fusion guidance for paravertebral nerve block
  107. Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
  108. Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
  109. Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
  110. Cell-free adipose extract inhibits hypertrophic scar formation through collagen remodeling and antiangiogenesis
  111. HALP score in Demodex blepharitis: A case–control study
  112. Assessment of SOX2 performance as a marker for circulating cancer stem-like cells (CCSCs) identification in advanced breast cancer patients using CytoTrack system
  113. Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
  114. Comparison of the two intestinal anastomosis methods in pediatric patients
  115. Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
  116. Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
  117. Lateral transperitoneal laparoscopic adrenalectomy: A single-centre experience of 21 procedures
  118. Petunidin attenuates lipopolysaccharide-induced retinal microglia inflammatory response in diabetic retinopathy by targeting OGT/NF-κB/LCN2 axis
  119. Procalcitonin and C-reactive protein as biomarkers for diagnosing and assessing the severity of acute cholecystitis
  120. Factors determining the number of sessions in successful extracorporeal shock wave lithotripsy patients
  121. Development of a nomogram for predicting cancer-specific survival in patients with renal pelvic cancer following surgery
  122. Inhibition of ATG7 promotes orthodontic tooth movement by regulating the RANKL/OPG ratio under compression force
  123. A machine learning-based prognostic model integrating mRNA stemness index, hypoxia, and glycolysis‑related biomarkers for colorectal cancer
  124. Glutathione attenuates sepsis-associated encephalopathy via dual modulation of NF-κB and PKA/CREB pathways
  125. FAHD1 prevents neuronal ferroptosis by modulating R-loop and the cGAS–STING pathway
  126. Association of placenta weight and morphology with term low birth weight: A case–control study
  127. Review Articles
  128. The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
  129. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  130. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  131. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  132. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  133. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  134. The application of augmented reality in robotic general surgery: A mini-review
  135. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  136. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  137. Plant polyphenols, terpenes, and terpenoids in oral health
  138. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  139. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  140. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  141. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  142. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
  143. Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
  144. Giant borderline ovarian tumours – review of the literature
  145. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
  146. Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
  147. Risk factors of frailty/sarcopenia in community older adults: Meta-analysis
  148. Supplement strategies for infertility in overweight women: Evidence and legal insights
  149. Scurvy, a not obsolete disorder: Clinical report in eight young children and literature review
  150. Case Reports
  151. Delayed graft function after renal transplantation
  152. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
  153. Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
  154. Giant right atrial hemangioma presenting with ascites: A case report
  155. Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
  156. EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation
  157. Rapid Communication
  158. Biological properties of valve materials using RGD and EC
  159. Letter to the Editor
  160. Role of enhanced external counterpulsation in long COVID
  161. Expression of Concern
  162. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  163. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  164. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  165. Corrigendum
  166. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  167. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  168. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  169. Retraction
  170. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  171. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
  172. Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
  173. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
  174. The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
  175. Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
  176. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  177. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  178. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  179. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  180. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  181. The mRNA MOXD1: Link to oxidative stress and prognostic significance in gastric cancer
  182. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  183. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  184. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  185. Special Issue Diabetes
  186. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  187. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  188. A discussion on the application of fluorescence micro-optical sectioning tomography in the research of cognitive dysfunction in diabetes
  189. A review of brain research on T2DM-related cognitive dysfunction
  190. Special Issue Biomarker Discovery and Precision Medicine
  191. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
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Heruntergeladen am 30.9.2025 von https://www.degruyterbrill.com/document/doi/10.1515/med-2025-1175/html
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