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Randomized Controlled Trial
. 2012 Jul;15(1):18-22.
doi: 10.1093/icvts/ivs118. Epub 2012 Apr 4.

Remote ischaemic preconditioning does not protect the heart in patients undergoing coronary artery bypass grafting

Vladimir V Lomivorotov  1 , Vladimir A Shmyrev, Valeriy A Nepomnyaschih, Dmitriy N Ponomarev, Lubov G Knyazkova, Vladimir N Lomivorotov, Alexandr M Karaskov
Affiliations
Randomized Controlled Trial

Remote ischaemic preconditioning does not protect the heart in patients undergoing coronary artery bypass grafting

Vladimir V Lomivorotov et al. Interact Cardiovasc Thorac Surg. 2012 Jul.

Abstract

Remote ischaemic preconditioning (RIPC) gained attention as a possibility to reduce myocardial injury after a subsequent sustained episode of myocardial ischaemia. This prospective randomized study was carried out to assess whether RIPC reduces myocardial injury in coronary artery bypass grafting patients. Eighty patients were assigned to remote preconditioning or control treatment. Ischaemic preconditioning was induced by three 5-min cycles of upper limb ischaemia and reperfusion after anaesthesia induction. Haemodynamic and markers of myocardial damage were analysed preoperatively and over 48 h postoperatively. The cardiac index was higher immediately after remote preconditioning in the main group. There were no differences in other haemodynamic, troponin I and creatine kinase-MB concentrations at any time point between groups. Thus, short-term remote preconditioning improves haemodynamics and does not reduce myocardial injury after coronary artery bypass surgery. Further study of high-risk patients may be needed to fully evaluate the clinical effect of RIPC.

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Figures

Figure 1:
Figure 1:
The area under the curve of troponin I over the 48 h after surgery in the RIPC group did not differ compared with the control group. Values presented are median (25th and 75th percentiles). RIPC: remote ischaemic preconditioning. cTnI: cardiac troponin I.
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