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Randomized Controlled Trial
. 2018 Mar 26;7(7):e008077.
doi: 10.1161/JAHA.117.008077.

RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study: Myocardial Dysfunction, Postoperative Neurocognitive Dysfunction, and 1 Year Follow-Up

Patrick Meybohm  1 , Madeline Kohlhaas  2 , Christian Stoppe  3 , Matthias Gruenewald  4 , Jochen Renner  4 , Berthold Bein  4   5 , Martin Albrecht  4 , Jochen Cremer  6 , Mark Coburn  3 , Gereon Schaelte  3 , Andreas Boening  7 , Bernd Niemann  7 , Michael Sander  8   9 , Jan Roesner  10   11 , Frank Kletzin  11 , Haitham Mutlak  2 , Sabine Westphal  2 , Rita Laufenberg-Feldmann  12 , Marion Ferner  12 , Ivo F Brandes  13 , Martin Bauer  13   14 , Sebastian N Stehr  15   16 , Andreas Kortgen  15 , Maria Wittmann  17 , Georg Baumgarten  17   18 , Tanja Meyer-Treschan  19 , Peter Kienbaum  19 , Matthias Heringlake  20 , Julika Schoen  20   21 , Sascha Treskatsch  9 , Thorsten Smul  22 , Ewa Wolwender  22 , Thomas Schilling  23 , Georg Fuernau  24 , Holger Bogatsch  25 , Oana Brosteanu  25 , Dirk Hasenclever  26 , Kai Zacharowski  2 ; RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study Collaborators
Collaborators, Affiliations
Randomized Controlled Trial

RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study: Myocardial Dysfunction, Postoperative Neurocognitive Dysfunction, and 1 Year Follow-Up

Patrick Meybohm et al. J Am Heart Assoc. .

Abstract

Background: Remote ischemic preconditioning (RIPC) has been suggested to protect against certain forms of organ injury after cardiac surgery. Previously, we reported the main results of RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study, a multicenter trial randomizing 1403 cardiac surgery patients receiving either RIPC or sham-RIPC.

Methods and results: In this follow-up paper, we present 1-year follow-up of the composite primary end point and its individual components (all-cause mortality, myocardial infarction, stroke and acute renal failure), in a sub-group of patients, intraoperative myocardial dysfunction assessed by transesophageal echocardiography and the incidence of postoperative neurocognitive dysfunction 5 to 7 days and 3 months after surgery. RIPC neither showed any beneficial effect on the 1-year composite primary end point (RIPC versus sham-RIPC 16.4% versus 16.9%) and its individual components (all-cause mortality [3.4% versus 2.5%], myocardial infarction [7.0% versus 9.4%], stroke [2.2% versus 3.1%], acute renal failure [7.0% versus 5.7%]) nor improved intraoperative myocardial dysfunction or incidence of postoperative neurocognitive dysfunction 5 to 7 days (67 [47.5%] versus 71 [53.8%] patients) and 3 months after surgery (17 [27.9%] versus 18 [27.7%] patients), respectively.

Conclusions: Similar to our main study, RIPC had no effect on intraoperative myocardial dysfunction, neurocognitive function and long-term outcome in cardiac surgery patients undergoing propofol anesthesia.

Clinical trial registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01067703.

Keywords: cardio‐vascular surgery; ischemia/reperfusion injury; remote ischemic preconditioning.

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Figures

Figure 1
Figure 1
Kaplan–Meier‐plots of proportion event‐free time to primary end point. Kaplan–Meier‐Plots are shown for the two intervention groups. Event‐free survival did not differ significantly between the two intervention groups (Cox regression analysis, with adjustment for the stratification variables). RIPC indicates remote ischemic preconditioning.
See this image and copyright information in PMC

References

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