Document Detail


Remote ischaemic preconditioning in coronary artery bypass surgery: a meta-analysis.
MedLine Citation:
PMID:  22875822     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
AIM: Randomised trials exploring remote ischaemic preconditioning (RIPC) in patients undergoing coronary artery bypass graft (CABG) surgery have yielded conflicting data regarding potential cardiovascular and renal protection, and are individually flawed by small sample size.
METHODS: Three investigators independently searched the MEDLINE, EMBASE and Cochrane databases to identify randomised trials testing RIPC in patients undergoing CABG.
RESULTS: Nine studies with 704 patients were included. Standardised mean difference of troponin I and T release showed a significant decrease (-0.36 (95% CI -0.62 to -0.09)). This difference held true after excluding the trials with cross-clamp fibrillation, the study with off-pump CABG and studies using a flurane as anaesthetic agent (-0.41 (95% CI -0.69 to -0.12), -0.38 (95% CI -0.70 to -0.07) and -0.37 (95% CI -0.63 to -0.12), respectively). A similar trend was also obtained for patients with multivessel disease (-0.41 (95% CI -0.73 to -0.08)). The trials evaluating postoperative creatinine reported a non-significant reduction (0.02 (95% CI -0.09 to 0.13)). Moreover, the length of in-hospital stay was not influenced by the kind of treatment (weighted mean difference 0.27 (95% CI -0.24 to 0.79)).
CONCLUSION: RIPC reduced the release of troponin in patients undergoing CABG. Larger randomised trials are needed to clarify the presence of a causal relationship between RIPC-induced troponin release and clinical adverse events.
Authors:
Fabrizio D'Ascenzo; Erika Cavallero; Claudio Moretti; Pierluigi Omedè; Filippo Sciuto; Ishtiaq A Rahman; Robert S Bonser; Jeon Yunseok; Robert Wagner; Tomas Freiberger; Gudrun Kunst; Michael S Marber; Matthias Thielmann; Bingyang Ji; Yasser M Amr; Maria Grazia Modena; Giuseppe Biondi Zoccai; Imad Sheiban; Fiorenzo Gaita
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  98     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1267-71     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, University of Turin, Turin, Italy; drclamore@yahoo.it.
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