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The effect of Remote Ischemic Post Conditioning to Prevent Reperfusion Injury in Primary Percutaneous Coronary Intervention
Indonesia (CIMSA-ISMKI) - Universitas Andalas, Padang
Cardiology and Vascular Medicine Division, M. Djamil Hospital, Jl. Perintis Kemerdekaan, Padang, West Sumatera 25171
M. Fadil, MD, FIHA
M. Fadil, MD, FIHA
Type of Research Project
- Clinical Project with Laboratory work
What is the background of the project?
Coronary heart disease (CHD) is one of the main causes of death. Based on data from the World Health Organization (WHO) in 2011 around 17.3 million people died due to cardiovascular disease, in which more than seven million people died from CHD. In Indonesia, based on the 2013 Basic Health Research, CHD was in the seventh highest position of Non-Communicable Diseases (NCD's) in Indonesia. The most cases were ischemic heart disease, which was around 110,183 cases. Many cases of ST elevation myocardial infarction use Primary Percutaneous Coronary Intervention (PPCI) therapy as the effective method to restrict the area of infarction, reduce clinical symptoms, and improve clinical prognosis. Reperfusion / ischemic injury is a pathophysiological process that often occurs, which poses a serious threat to patient health. Reperfusion / ischemic injury can cause further damage to the myocardium causing cell dysfunction and death. However, PPCI makes reperfusion injury which will resultinthe prognosis become worsen. Remote ischemic postconditioning (RIPostC) is a protective strategy for reperfusion injury.
What is the aim of the project?
To understand the mechanism and effect of Remote Ischemic Post Conditioning preventing the reperfusion injury
What techniques and methods are used?
Experimental research with a posttest method with a control group (posttest only control group design), namely the design used to measure the effect of treatment in the experimental group by comparing treatment results with the control group at the end of treatment time ST-Elevation (STEMI) patients who underwent the PPCI procedure will performed RIPostC procedure. All eligible patients were prepared with a limb cuff wrapped around the upper arm before arterial puncture. In the treatment group, the protocol was started within one minute of the first balloon dilatation. The upper arm was exposed to four cycles of ischemia-reperfusion, each with 5 minutes of cuff inflation at 200 mmHg, followed by 5 minutes of complete deflation. To see if the RIPostC procedure induce body to achive a threshold to produce protective information and effective in protecting against reperfusion injury. After the procedure there wil be data analysis be performed using statistical package for social sciences (SPSS)
What is the role of the student?
- The student will mainly observe
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- The tasks of the student will be performed on his/her own
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
1. Manage the patient and fill out the worksheet 2. Check and monitor the patient's vital signs 3. Check inflation and deflation of sphygmomanometers 4. Following PPCI and RIPC procedures 5. Do examination of heart function with echocardiography to the patient 6. Make literature review 7. Collect data 8. Analyze data using statistical package for social sciences (SPSS) 9. Make an abstract 10. Final presentation at the end of research exchange program
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Yes, it will be teach by M. Fadil, MD, FIHA as the tutor and also members of the research. Twice a week, preliminary readings and lectures.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student’s name will be mentioned in a future publication - The student will have the opportunity to present the results together with the supervisor at a conference
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Interest in cardiology To be able to operate statistical package for social sciences (SPSS) is preferable
Are there any legal limitations in the student’s involvement
In term of clinical procedure, students are allowed to observe only
Type of students accepted
This project accepts: - Medical students - Graduated students (less than 6 months)
- Remote Ischemic Postconditioning (RIPC) of the Upper Arm Results in Protection from Cardiac Ischemia-Reperfusion Injury Following Primary Percutaneous Coronary Intervention (PCI) for Acute ST-Segment Elevation Myocardial Infarction (STEMI). Med Sci Monit [Internet]. 2018;24:1017–1026
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