Remote Ischemic Preconditioning and Outcomes of Cardiac Surgery

Monday, October 5, 2015

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Source

Source Name: New England Journal of Medicine

Source URL: http://www.nejm.org/doi/full/10.1056/NEJMoa1413534?query=OF

Author(s)

Derek J. Hausenloy, Luciano Candilio, Richard Evans, Cono Ariti, David P. Jenkins, Shyam Kolvekar, Rosemary Knight, Gudrun Kunst, Christopher Laing, Jennifer Nicholas, John Pepper, Steven Robertson, Maria Xenou, Tim Clayton, and Derek M. Yellon for the ERICCA Trial Investigators

Pts undergoing CABG on-pump were randomized to remote preconditioning (upper arm ischemia) or sham intervention prior to surgical incision. The primary end point was a combination of cardiovascular death, stroke, MI, and revascularization. At 1 year there was no difference between the groups in the incidence of the end point, and other important clinical outcomes were also similar.

Comments

Submitted by Kyriacos Kolocassides on Sat, 2015-10-17 05:14

Well, to keep it short, academically I am of the opinion that the kind of injury expected in such studies will not be influenced by ischemic preconditioning. Looking at arrhythmias (a surrogate all be it) would be more productive. However, in terms of the real world out there and possible practical application of the phenomenon, this is a very useful negative study. I wonder if the numbers allow to study sub groups with particularly long ischemic times ... KK