Remote ischaemic preconditioning for coronary artery bypass grafting (with or without valve surgery)

Benstoem, Carina; Stoppe, Christian; Liakopoulos, Oliver J.; Ney, Julia; Hasenclever, Dirk; Meybohm, Patrick; Goetzenich, Andreas

doi:10.1002/14651858.cd011719.pub3

Cited by 31 publications

(33 citation statements)

References 83 publications

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“…Similar findings were observed in the ERICCA Study including 1612 surgery cardiac patients with no significant benefits 1 year after surgery. Very recently, we performed a Cochrane meta‐analysis and found no evidence that RIPC has a treatment effect on clinical outcomes (measured as a composite end point including all‐cause mortality, non‐fatal myocardial infarction or any new stroke, or both, assessed at 30 days after surgery), while we found moderate‐quality evidence that RIPC reduces the cardiac troponin T and I release measured at 72 hours after surgery.…”

Section: Discussionmentioning

confidence: 73%

“…Similar findings were observed in the ERICCA Study 9 including 1612 surgery cardiac patients with no significant benefits 1 year after surgery. Very recently, we performed a Cochrane meta-analysis 21 and found no evidence that RIPC has a treatment effect on 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).…”

Section: Discussionmentioning

confidence: 98%

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

Meybohm

Kohlhaas

Stoppe

et al. 2018

JAHA

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BackgroundRemote 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 ResultsIn 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.ConclusionsSimilar 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 RegistrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT01067703.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 98%

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

Meybohm

Kohlhaas

Stoppe

et al. 2018

JAHA

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“…Several approaches have been implemented to reduce the risk during surgery (hypothermia, cardioplegic solutions, and the limitation of procedure times). These strategies have led to a pronounced reduction in mortality and morbidity; however, biomarkers of ischemia indicate persisting postoperative myocardial damage [10,11].…”

Section: Discussionmentioning

confidence: 99%

On-Pump versus Off-Pump Coronary Artery Bypass Grafting in The Surgical Management of High-Risk Patients, A Clinical Randomized Study

Omara

Wahdan

Elgazzar

et al. 2020

Egypt. Cardiothoracic. Surg.

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Background: Surgical treatment modalities of coronary artery diseases (CAD) include on-pump or off-pump coronary artery bypass grafting (CABG). CABG performed on the beating heart can avoid complications that might occur on cardiopulmonary bypass. Our objective was to compare the effectiveness of on-pump versus off-pump CABG in high-risk patients stratified according to the EuroSCORE scoring system. Methods: This randomized clinical study included 80 high-risk patients who underwent CABG and assigned into two groups; each contains 40 patients. Patients with valvular affection, ischemic ventricular septal defect or left ventricle and aortic aneurysms, and/or those exhibiting significant neurological pathology were excluded from the study. Study outcomes were blood loss, length of ICU and hospital stay, inotropic use, re-exploration rate, and operative mortality. Results: The study showed significant higher use of inotropic drugs intra and post-operatively (57.5% vs 40%, p = 0.021), more low cardiac output (12.5% vs 2.5%, p = 0.031), lower blood loss (337±67 vs 498±68 ml, p = 0.01), lower blood transfusion (1.1±0.2 vs 1.2±0.4 unit, p = 0.024), more prolonged ICU stay (4.0±1.6 vs 3.0±0.9 day, p = 0.001) and the higher re-exploration rate (17.5% vs 7.5%, p = 0.035) in the on-pump group. Hospital stay (8.7±2 vs 8.1±1, p = 0.121) and early mortality (7.5% vs 2.5%, p = 0.451) did not differ significantly between the two groups. Conclusion: Management of coronary artery disease is still challenging, and there is still a place for off-pump CABG in CAD in high-risk patients due to its advantages in the early complications while has the same total hospital stay when compared with on-pump CABG.

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“…They found that women were older than men and had different risk factors compared to men, these results were in accordance to ours. Benstoem et al (18) studied remote ischemic preconditioning for coronary artery bypass grafting and found that the mean age of his patients was 64± 11.5 years old. The age incidence of MI was earlier in Saudi Arabia, Khalid et al (19) concluded that the mean age ± SD of his MI patients was 58 ± 12.9 years in Saudi nationals on searching the baseline characteristics, management practices, and in-hospital outcomes of patients with acute coronary syndromes in the Saudi project for assessment of coronary events (SPACE) registry.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Acute Myocardial Infarction (AMI) in Taif City Province and Its Participating Factors

Alzahrani

Alotaibi

Margoushy

et al. 2018

Egyptian Journal of Hospital Medicine

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Background: Myocardial infarction (MI) is a fatal disease caused by block in the oxygen supply of blood vessels of the heart muscles, leading to permanent heart muscle damage and death of its cells. Aim of work: to assess the relationship between incidence of acute myocardial infarction and its participating factors. Patients and methods: observational, descriptive correlation questionnaire based study on 50 Saudi and non Saudi patients with acute myocardial infarction who were admitted in cardiac intensive care unit (CICU), medical ward and followed in outpatient department (OPD). They were chosen from King Faisal Medical Center, cardiology department, Taif, Saudi Arabia from the first of March 2016 to the end of April 2016 (2 months duration). Results: Prevalence of MI patients in the 2 months of research was 1.4%. MI was precipitated by a number of factors in Saudi Arabia as old age, increased body mass index, stress, obesity and consumption of high caloric rich diet. Conclusion: The main risk factors of ACS in our patients were hypertension, Stress, obesity; high cholesterol diet and positive family history of cholesterol in addition to old age and smoking.

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Remote ischaemic preconditioning for coronary artery bypass grafting (with or without valve surgery)

Cited by 31 publications

References 83 publications

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

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

On-Pump versus Off-Pump Coronary Artery Bypass Grafting in The Surgical Management of High-Risk Patients, A Clinical Randomized Study

The Prevalence of Acute Myocardial Infarction (AMI) in Taif City Province and Its Participating Factors

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