scholarly journals Effect of Remote Ischemic Preconditioning on Perioperative Cardiac Events in Patients Undergoing Elective Percutaneous Coronary Intervention: A Meta-Analysis of 16 Randomized Trials

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Xiangming Wang ◽  
Na Kong ◽  
Chuanwei Zhou ◽  
Deeraj Mungun ◽  
Zakaria Iyan ◽  
...  
Keyword(s):  
Ischemic Preconditioning ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Remote Ischemic Preconditioning ◽  
Cochrane Library ◽  
Control Group ◽  
Cardiac Events ◽  
Renal Protection ◽  
Elective Percutaneous Coronary Intervention

Background. The main objective of this meta-analysis was to investigate whether remote ischemic preconditioning (RIPC) reduces cardiac and renal events in patients undergoing elective cardiovascular interventions. Methods and Results. We systematically searched articles published from 2006 to 2016 in PubMed, EMBASE, Web of Science, Cochrane Library, and Google Scholar. Odds ratios (ORs) with 95% confidence intervals (CIs) were used as the effect index for dichotomous variables. The standardized mean differences (SMDs) with 95% CIs were calculated as the pooled continuous effect. Sixteen RCTs of 2435 patients undergoing elective PCI were selected. Compared with control group, RIPC could significantly reduce the incidence of perioperative myocardial infarction (OR = 0.64; 95% CI: 0.48–0.86; P=0.003) and acute kidney injury (OR = 0.56; 95% CI: 0.322–0.99; P=0.049). Metaregression analysis showed that the reduction of PMI by RIPC was enhanced for CAD patients with multivessel disease (coef.: −0.05 [-0.09;-0.01], P=0.022). There were no differences in the changes of cTnI (P=0.934) and CRP (P=0.075) in two groups. Conclusion. Our meta-analysis of RCTs demonstrated that RIPC can provide cardiac and renal protection for patients undergoing elective PCI, while no beneficial effect on reducing the levels of cTnI and CRP after PCI was reported.

scholarly journals A Randomized Controlled Study of Remote Ischemic Preconditioning for Prevention of Contrast-Induced Nephropathy

2019 ◽  
Vol 12 (1) ◽  
pp. 72-76
Author(s):  
Krishnaswamy Sampathkumar ◽  
Ratchagan Saravanan
Keyword(s):  
Ischemic Preconditioning ◽  
Simple Procedure ◽  
Kidney Injury ◽  
Remote Ischemic Preconditioning ◽  
Controlled Study ◽  
Control Group ◽  
Open Label ◽  
Group 4 ◽  
Intravenous Saline ◽  
Contrast Exposure

Introduction: Remote Ischemic Preconditioning (RIPC) is a technique which applies brief periods of reversible ischemia and reperfusion to limbs provoking adaptive protective responses to distant organs like Heart, Kidneys and Brain. Methods: Its efficacy in the prevention of Contrast Nephropathy was tested in our open-label, randomized and sham- controlled study. 100 patients with Chronic Kidney Disease Stages 1-3a requiring Contrast agent for Percutaneous Coronary Interventions were included. Subjects were randomized in a 1:1 ratio to receive either Remote Ischemic Preconditioning (RIPC) or sham preconditioning. Results & Discussion: Both groups were treated with Intravenous saline therapy before contrast exposure. The primary end point was contrast-Induced AKI. Baseline characteristics were comparable in both groups. Mean GFR in ml/min was similar in both groups (RIPC 54.8+/- 9 ml/min; Control 54.8+/- 9 ml/min) . Contrast-induced AKI occurred in 19/50 patients in control group and 6/50 in IPC group (p = 0.005).Hemodialysis was required only in control group (4/50) (p = 0.058). 30 day rehospitalization was more in control group (8 / 50) than RIPC group (1/50) (p = 0.01). RIPC was well- tolerated without adverse effects. Conclusion: In conclusion, remote ischemic preconditioning applied before contrast exposure prevents contrast-induced acute kidney injury in CKD 3a. This simple procedure can be added to intravenous saline therapy for nephroprotection.

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