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RESEARCH PRODUCT
RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study: Myocardial Dysfunction, Postoperative Neurocognitive Dysfunction, and 1 Year Follow-Up
Patrick MeybohmMadeline KohlhaasAndreas BoeningBernd NiemannMichael SanderJan RoesnerFrank KletzinHaitham MutlakSabine WestphalRita Laufenberg-feldmannMarion FernerIvo F. BrandesChristian StoppeMartin BauerSebastian N. StehrAndreas KortgenMaria WittmannGeorg BaumgartenTanja Meyer-treschanPeter KienbaumMatthias HeringlakeJulika SchoenSascha TreskatschMatthias GruenewaldThorsten SmulEwa WolwenderThomas SchillingGeorg FuernauHolger BogatschOana BrosteanuDirk HasencleverKai ZacharowskiRipheart (Remote Ischemic Preconditioning For Heart Surgery) Study CollaboratorsAna StevanovicJochen RennerRolf RossaintMarc FelzenAndreas GoetzenichTobias MoormannKatharina ChalkPascal KnuefermannThomas RechtAndreas HoeftMichael WinterhalterSonja IkenBerthold BeinCarolin WiedenbeckGerhard SchwarzmannSimone LindauAndreas ZiererStephan FichtlschererGerold GoerlachMatthias WollbrueckUrsula BoeningMarkus WeigandJulia StrauchmannMartin AlbrechtKai U. MorsbachMarkus PaxianKonrad ReinhardJens ScholzJochen RennerOle BrochHelga FrancksenBernd KuhrHermann HeinzeHauke PaarmannJochen CremerHans-hinrich SieversStefan KlotzThomas HachenbergChristian WernerSusanne MauffAngela AlmsStefan BergtNorbert RoewerMark CoburnGereon Schaeltesubject
medicine.medical_specialtyTime FactorsMyocardial InfarctionNeurocognitive DisordersMyocardial Reperfusion InjuryNeuropsychological Tests030204 cardiovascular system & hematologyischemia/reperfusion injuryRisk Assessment03 medical and health sciencesCognition0302 clinical medicineDouble-Blind MethodRisk FactorsIschemiaGermanyMulticenter trialClinical StudiesClinical endpointHumansMedicineProspective Studies030212 general & internal medicineMyocardial infarctionCardiac Surgical ProceduresProspective cohort studyPropofolStrokeOriginal ResearchCardiovascular Surgerycardio‐vascular surgerybusiness.industryIncidenceProtective Factorsmedicine.diseaseSurgeryCardiac surgeryTreatment OutcomeIschemic Preconditioning MyocardialIschemic preconditioningremote ischemic preconditioningCardiology and Cardiovascular MedicinebusinessPropofolAnesthetics IntravenousEchocardiography Transesophagealmedicine.drugdescription
Background Remote 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 Results In 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. Conclusions Similar 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 Registration URL: https://www.clinicaltrials.gov . Unique identifier: NCT 01067703.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2018-01-01 |