OBJECTIVES: Although remote ischemic preconditioning (RIPC) has shown favorable effects on ischemia-reperfusion injury, much remains unknown of its mechanisms and clinical significance. We hypothesized that RIPC would reduce the incidence of postoperative atrial fibrillation (POAF) following coronary artery bypass graft (CABG) surgery. In addition, we investigated whether RIPC could induce alterations of circulating microRNA in blood plasma. DESIGN: This is a single-center, double-blind, randomized controlled trial. 92 adult patients referred for first-time isolated CABG surgery were randomly assigned to either RIPC (n = 45) or control (n = 47). The RIPC-stimulus comprised three 5-min cycles of upper arm ischemia, induced by inflating a blood pressure cuff to 200 mmHg, with an intervening 5 min reperfusion. Heart rhythm was assessed by telemetry. MicroRNA expression was assessed in plasma by real-time polymerase chain reaction. RESULTS: Of the 92 patients included in the study, 27 patients developed POAF (29%). 17 of these patients belonged to the RIPC group (38%), and 10 to the control group (21%). There were no significant alterations of microRNA expression. CONCLUSIONS: We did not observe a reduced incidence of POAF by RIPC before CABG surgery. Larger multi-center studies may be necessary to further clarify this issue.
RCT Entities:
OBJECTIVES: Although remote ischemic preconditioning (RIPC) has shown favorable effects on ischemia-reperfusion injury, much remains unknown of its mechanisms and clinical significance. We hypothesized that RIPC would reduce the incidence of postoperative atrial fibrillation (POAF) following coronary artery bypass graft (CABG) surgery. In addition, we investigated whether RIPC could induce alterations of circulating microRNA in blood plasma. DESIGN: This is a single-center, double-blind, randomized controlled trial. 92 adult patients referred for first-time isolated CABG surgery were randomly assigned to either RIPC (n = 45) or control (n = 47). The RIPC-stimulus comprised three 5-min cycles of upper arm ischemia, induced by inflating a blood pressure cuff to 200 mmHg, with an intervening 5 min reperfusion. Heart rhythm was assessed by telemetry. MicroRNA expression was assessed in plasma by real-time polymerase chain reaction. RESULTS: Of the 92 patients included in the study, 27 patients developed POAF (29%). 17 of these patients belonged to the RIPC group (38%), and 10 to the control group (21%). There were no significant alterations of microRNA expression. CONCLUSIONS: We did not observe a reduced incidence of POAF by RIPC before CABG surgery. Larger multi-center studies may be necessary to further clarify this issue.
Entities:
Keywords:
coronary artery bypass; ischemic preconditioning; postoperative period; preoperative care
Authors: Carina Benstoem; Christian Stoppe; Oliver J Liakopoulos; Julia Ney; Dirk Hasenclever; Patrick Meybohm; Andreas Goetzenich Journal: Cochrane Database Syst Rev Date: 2017-05-05
Authors: Nicoline W E van den Berg; Makiri Kawasaki; Wouter R Berger; Jolien Neefs; Eva Meulendijks; Anke J Tijsen; Joris R de Groot Journal: Cardiovasc Drugs Ther Date: 2017-06 Impact factor: 3.727
Authors: Amir S Lotfi; Hossein Eftekhari; Auras R Atreya; Ananth Kashikar; Senthil K Sivalingam; Miguel Giannoni; Paul Visintainer; Daniel Engelman Journal: World J Cardiol Date: 2016-10-26