The EUROpean and Chinese cardiac and renal Remote Ischemic Preconditioning Study (EURO-CRIPS CardioGroup I): A randomized controlled trial

Moretti, Claudio; Cerrato, Enrico; Cavallero, Erika; Lin, Song; Rossi, Marco; Picchi, Andrea; Sanguineti, Francesca; Ugo, Fabrizio; Palazzuoli, Alberto; Bertaina, Maurizio; Presbitero, Patrizia; Chen, Shao‐Liang; Pozzi, Roberto; Giammaria, Massimo; Limbruno, Ugo; Lefèvre, Thierry; Gasparetto, Valeria; Garbo, Roberto; Omedè, Pierluigi; Sheiban, Imad; Escaned, Javier; Biondi‐Zoccai, Giuseppe; Gaïta, Fiorenzo; Perl, Leor; D’Ascenzo, Fabrizio

doi:10.1016/j.ijcard.2017.12.033

Cited by 51 publications

(37 citation statements)

References 26 publications

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“…In 2 out of 18 articles, patients were identified and randomized 1:1 with computer‐generated block randomization (Crimi et al, ; Yamanaka et al, ), while in the other studies, the randomization method was mentioned without a specific description. Eight studies reported completeness of follow‐up (Crimi et al, ; Deftereos et al, ; Elbadawi et al, ; Er et al, ; Hoole et al, ; Menting et al, ; Moretti et al, ; Zhou et al, ), and almost all of the studies included patients with similar baseline characteristics and provided details about the inclusion criteria and the intention‐to‐treat analysis. The literature quality scores are shown in Table .…”

Section: Resultsmentioning

confidence: 99%

“…We separated 18 studies into three groups according to the dose of CM administered: ≤100 ml group (low) 1 (Cao et al, ; Ferdinandy et al, ; Gholoobi et al, ; Igarashi et al, ), 100–200 ml group (medium) 1 (Balbir Singh et al, ; Bøtker et al, ; Er et al, ; Ferdinandy et al, ; Giricz et al, ; Han et al, ; Hausenloy et al, ; Hausenloy & Yellon, ; Hoole et al, ; Luo et al, ; Moretti et al, ; Narula et al, ; Sadat et al, ; Savaj et al, ; White et al, ; Xu et al, ; Yamanaka et al, ; Zagidullin et al, ; Zhou et al, , ), and >200 ml group (high) 2 (Deftereos et al, ; Sadat et al, ). RIC significantly decreased the incidence of CIN in all three groups (low group: OR = 0.29, 95% CI 0.14, 0.60, p < .05; medium group: OR = 0.47, 95% CI 0.34, 0.64; p < .05; and high group: OR = 0.47, 95% CI 0.26, 0.56; p < .05; Table ).…”

Section: Resultsmentioning

confidence: 99%

“…RIC significantly decreased the incidence of CIN in all three groups (low group: OR = 0.29, 95% CI 0.14, 0.60, p < .05; medium group: OR = 0.47, 95% CI 0.34, 0.64; p < .05; and high group: OR = 0.47, 95% CI 0.26, 0.56; p < .05; Table ). Furthermore, we compared low‐osmolar and iso‐osmolar contrast agents focusing on renal safety and found that RIC decreased the rate of CIN in the low‐osmolar contrast group (Cao et al, ; Deftereos et al, ; Er et al, ; Hoole et al, ; Igarashi et al, ; Luo et al, ; Menting et al, ; Moretti et al, ; Yamanaka et al, ; Zagidullin et al, ) (OR = 0.32; 95% CI 0.23, 0.45; p < .05); however, RIC was not effective in either the iso‐osmolar contrast agent groups (Balbir Singh et al, ; Gholoobi et al, ) (OR = 0.75; 95% CI 0.31, 1.83; p = .52) or groups for which the contrast media type was not mentioned (OR = 0.66; 95% CI 0.41, 1.06; p = .09; Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Based on the inclusion and exclusion criteria, 18 relevant studies were included. The study selection process is shown in Figure 1 (Balbir Singh et al, 2016;Cao, Wang, Zhang, Xia, & Yang, 2018;Crimi et al, 2013;Deftereos et al, 2013;Elbadawi et al, 2017;Er et al, 2012;Gholoobi, Sajjadi, Shabestari, Eshraghi, & Shamloo, 2015;Hoole et al, 2009;Igarashi, Iino, Watanabe, & Ito, 2013;Lavi et al, 2014;Luo et al, 2013;Menting et al, 2015;Moretti et al, 2018;Savaj, Savoj, Jebraili, & Sezavar, 2014;Xu et al, 2015;Yamanaka et al, 2015;Zagidullin et al, 2017;Zhou et al, 2018).…”

Section: Study Selectionmentioning

confidence: 99%

“…Our meta-analysis included 2,503 patients from 18 studies, of which 1,243 patients receiving RIC before or after surgery were assigned to the experimental group, and the remaining 1,260 patients were assigned to the control group. Two trials defined CIN as a relative increase of >25% from baseline (Crimi et al, 2013;Hoole et al, 2009); two trials used the definition of either an absolute increase in Scr > 0.5 mg/dl or 44.2 mmol/L or a relative increase of >25% from baseline within 16 hr after CM exposure (Luo et al, 2013;Xu et al, 2015), one trial used the same criteria as above within 24 hr after exposure (Lavi et al, 2014), three trials within 48 hr after exposure (Balbir Singh et al, 2016;Moretti et al, 2018;Zagidullin et al, 2017), three trials between 48 and 72 hr after exposure (Menting et al, 2015;Yamanaka et al, 2015;Zhou et al, 2018), one trial within 72 hr after exposure (Cao et al, 2018), and three trials within 96 hr after exposure (Deftereos et al, 2013;Elbadawi et al, 2017;Zagidullin et al, 2017); and two trials used the definition of an absolute increase in Scr of 0.3 mg/dl within 24 or 48 hr of exposure to the contrast agent (Gholoobi et al, 2015;Savaj et al, 2014). The mean CM dose ranged from 77.7 to 270 ml.…”

Section: Study Selectionmentioning

confidence: 99%

See 4 more Smart Citations

The efficacy of remote ischemic conditioning in preventing contrast‐induced nephropathy among patients undergoing coronary angiography or intervention: An updated systematic review and meta‐analysis

Zhan

Zhu

et al. 2019

Noninvasive Electrocardiol

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Background Numerous trials have investigated the effect of remote ischemic conditioning (RIC) in preventing contrast‐induced nephropathy (CIN) in patients receiving contrast medium (CM). This meta analysis aims to validate the role of RIC in preventing CIN. Methods We searched the PubMed, EMBASE, and Web of Science databases for eligible randomized controlled trials (RCTs) published before April 27, 2019. Two investigators independently extracted basic characteristics from each study. Odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were used to examine the treatment effect. Results A total of 18 studies comprising 2,503 patients were included in our meta‐analysis. Compared with conventional therapy, RIC significantly reduced the risk of CIN (OR = 0.43, 95% CI: 0.33, 0.56, p < .05). Subgroup analyses showed that the protective effect of RIC was stronger in the low‐osmolar contrast media group (OR = 0.32; 95% CI: 0.23, 0.45, p < .05) and the nondiabetic group (OR = 0.39; 95% CI: 0.29, 0.53 p < .05). RIC also significantly reduced major adverse cardiovascular events within the first 6 months (OR = 0.39; p < .05), but the influence was not present after long‐term follow‐up. Conclusions Our meta‐analysis showed that RIC could effectively reduce CIN risk and decrease the short‐term incidence of relevant adverse events. Furthermore, the effects of CIN are more pronounced in nondiabetic patients and with the use of low‐osmolar contrast medium. This meta‐analysis of small trials suggests a possible protective effect of RIC on contrast‐induced nephropathy and favors the performance of a large randomized trial to further investigate this strategy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

See 3 more Smart Citations

The efficacy of remote ischemic conditioning in preventing contrast‐induced nephropathy among patients undergoing coronary angiography or intervention: An updated systematic review and meta‐analysis

Zhan

Zhu

et al. 2019

Noninvasive Electrocardiol

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Renal Insufficiency and the Impact of Contrast Agents

Briguori¹,

Donahue²,

D’Amore³

2022

Interventional Cardiology

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Remote ischemic preconditioning reduces the incidence of contrast‐induced nephropathy in patients undergoing coronary angiography/intervention: Systematic review and meta‐analysis of randomized controlled trials

Pranata

Tondas

Vania

et al. 2020

Cathet Cardio Intervent

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Background: Contrast-induced nephropathy (CIN) is associated with increased mortality and morbidity in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention (PCI). We aimed to assess the latest evidence on the effect of remote ischemic preconditioning (RIPC) on the incidence of CIN in patients undergoing CAG/PCI. Methods: We performed a comprehensive search on topics assessing RIPC and CIN in CAG/PCI patients from inception up until July 2019 through several electronic databases. Results: There were a total of 1,925 subjects from 14 randomized controlled trials. Remote ischemic preconditioning was associated with reduced CIN incidence in patients undergoing CAG/PCI (OR 0.41 [0.30, 0.55], p < .001; I 2 : 22%). The nephroprotective effect was also demonstrated in those at moderate-high risk for CIN subgroup (OR 0.41 [0.29, 0.58], p < .001; I 2 : 26%) and PCI-only subgroup (OR 0.41 [0.29, 0.58], p < .001; I 2 : 0%). Time from RIPC to CAG/PCI has similar effectiveness among ≤45, ≤60, and ≤120 min. Mortality, rehospitalization, hemodialysis, and major adverse events were lower in the RIPC group (OR 0.50 [0.33, 0.76], p = .001; I 2 : 0%). Grading of recommendations assessment, development and evaluation (GRADE) assessment showed that RIPC has high evidence certainty for reducing CIN in patients undergoing PCI/CAG, moderate-high risk subgroup, and PCI-only subgroup with absolute reduction of 97 per 1,000, 129 per 1,000, and 121 per 1,000, respectively. Harbord test showed no evidence for the presence of small-study effects (p = .157). Conclusions: Remote ischemic preconditioning is an effective procedure to reduce the risk of CIN and should be considered in patients with moderate-high risk at developing CIN.

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The EUROpean and Chinese cardiac and renal Remote Ischemic Preconditioning Study (EURO-CRIPS CardioGroup I): A randomized controlled trial

Cited by 51 publications

References 26 publications

The efficacy of remote ischemic conditioning in preventing contrast‐induced nephropathy among patients undergoing coronary angiography or intervention: An updated systematic review and meta‐analysis

The efficacy of remote ischemic conditioning in preventing contrast‐induced nephropathy among patients undergoing coronary angiography or intervention: An updated systematic review and meta‐analysis

Renal Insufficiency and the Impact of Contrast Agents

Remote ischemic preconditioning reduces the incidence of contrast‐induced nephropathy in patients undergoing coronary angiography/intervention: Systematic review and meta‐analysis of randomized controlled trials

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