Remote Ischemic Conditioning in Pediatric Cancer Patients Receiving Anthracycline Chemotherapy

Health position paper and redox perspectives on reactive oxygen species as signals and targets of cardioprotection

“…7 ). The effect of RIC to prevent anthracycline cardiotoxicity has been tested in 2 very recent very small pilot trials, one in an adult population [ 313 ], and another in a pediatric one [ 314 ]. Both trials were neutral for the primary endpoint (release of cTn), however cardiotoxicity (as defined by clinical practice guidelines [ 293 ] was not observed in patients in any of the trials.…”

Remote Ischemic Conditioning for Anthracycline Cardiotoxicity

“…In the trial by Mallouppas et al, 17 although the cumulative dose was relatively high, patients did not have other high-risk features (eg, only 9% had hypertension, 4% diabetes, and mean age was <50 years). In the trial by Cheung et al, 18 the cumulative dose was relatively low, and no other risk factors were present. Another very relevant aspect is the primary endpoint chosen in both studies: cTn levels.…”

“…They were randomized to RIC (3 cycles of 5-minute arm ischemia followed by 5-minute reperfusion) or sham before each chemotherapy cycle. 18 The mean cumulative dose of anthracycline was low (155 to 157 mg/m 2 ). The primary endpoint, also circulating levels of cTn, was not different between groups.…”

“…In a separate trial also published in this issue JACC: CardioOncology , Cheung et al 18 tested the effects of RIC in a pediatric population of 68 patients (mean age 11 years) with different cancers. They were randomized to RIC (3 cycles of 5-minute arm ischemia followed by 5-minute reperfusion) or sham before each chemotherapy cycle.…”