Format

Send to

Choose Destination
See comment in PubMed Commons below
J Cardiothorac Vasc Anesth. 2014 Jun;28(3):682-9. doi: 10.1053/j.jvca.2013.05.035. Epub 2013 Oct 5.

Remote ischemic preconditioning reduces cardiac troponin I release in cardiac surgery: a meta-analysis.

Author information

1
Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
2
Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address: guyanwang2006@163.com.
3
Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
4
Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Abstract

OBJECTIVES:

To determine whether remote ischemic preconditioning (RIPC) reduces myocardial injury, mortality, morbidity, and resource utilization in cardiac surgery.

DESIGN:

Meta-analysis of controlled clinical trials. The primary outcome was cardiac troponin I (cTnI) concentrations. Secondary outcomes included cardiac troponin T (cTnT) concentrations, myocardial infarction, stroke, renal failure requiring hemodialysis, atrial fibrillation, inotropic score, mechanical ventilation time, length of intensive care unit stay, length of hospital stay, and death.

SETTING:

University hospitals.

PATIENTS:

Adult and pediatric patients undergoing cardiac surgery, including coronary artery bypass grafting, valve procedures, and correction of congenital cardiac anomalies.

INTERVENTIONS:

Remote ischemic preconditioning through limb ischemia.

MEASUREMENTS AND MAIN RESULTS:

Nineteen randomized trials involving 1,235 patients were included in the meta-analysis. The cTnI concentrations at 6 (or 4-8) hours postoperatively and the total cTnI released after surgery showed a statistically significant reduction in the RIPC group compared with a control group (weighted mean difference [WMD] -2.03 ug/L, 95% confidence interval [CI] -3.25 to -0.82 ug/L, p = 0.001; WMD -65.74 ug/L*h, 95% CI -107.88 to -23.61 ug/L*h, p = 0.002, respectively). There were no differences in mortality, morbidity, and resource utilization between groups.

CONCLUSIONS:

Current evidence suggests that RIPC reduces cardiac troponin I release in patients undergoing cardiac surgery. The clinical significance of these observations merits further investigation.

KEYWORDS:

cardiac; myocardial injury; myocardial protection; preconditioning; remote ischemic preconditioning

PMID:
24103716
DOI:
10.1053/j.jvca.2013.05.035
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center