RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study: Myocardial Dysfunction, Postoperative Neurocognitive Dysfunction, and 1 Year Follow‐Up. Issue 7 (26th March 2018)

• Record Type: Journal Article
• Authors: Meybohm, Patrick; Kohlhaas, Madeline; Stoppe, Christian; Gruenewald, Matthias; Renner, Jochen; Bein, Berthold; Albrecht, Martin; Cremer, Jochen; Coburn, Mark; Schaelte, Gereon; Boening, Andreas; Niemann, Bernd; Sander, Michael; Roesner, Jan; Kletzin, Frank; Mutlak, Haitham; Westphal, Sabine; Laufenberg‐Feldmann, Rita; Ferner, Marion; Brandes, Ivo F.; Bauer, Martin; Stehr, Sebastian N.; Kortgen, Andreas; Wittmann, Maria; Baumgarten, Georg; Meyer‐Treschan, Tanja; Kienbaum, Peter; Heringlake, Matthias; Schoen, Julika; Treskatsch, Sascha; Smul, Thorsten; Wolwender, Ewa; Schilling, Thomas; Fuernau, Georg; Bogatsch, Holger; Brosteanu, Oana; Hasenclever, Dirk; Zacharowski, Kai;
• Other Names: Stevanovic Ana investigator.; Rossaint Rolf investigator.; Felzen Marc investigator.; Goetzenich Andreas investigator.; Moormann Tobias investigator.; Chalk Katharina investigator.; Knuefermann Pascal investigator.; Recht Thomas investigator.; Hoeft Andreas investigator.; Winterhalter Michael investigator.; Iken Sonja investigator.; Wiedenbeck Carolin investigator.; Schwarzmann Gerhard investigator.; Lindau Simone investigator.; Zierer Andreas investigator.; Fichtlscherer Stephan investigator.; Goerlach Gerold investigator.; Wollbrueck Matthias investigator.; Boening Ursula investigator.; Weigand Markus investigator.; Strauchmann Julia investigator.; Morsbach Kai U. investigator.; Paxian Markus investigator.; Reinhard Konrad investigator.; Scholz Jens investigator.; Renner Jochen investigator.; Broch Ole investigator.; Francksen Helga investigator.; Kuhr Bernd investigator.; Heinze Hermann investigator.; Paarmann Hauke investigator.; Sievers Hans‐Hinrich investigator.; Klotz Stefan investigator.; Hachenberg Thomas investigator.; Werner Christian investigator.; Mauff Susanne investigator.; Alms Angela investigator.; Bergt Stefan investigator.; Roewer Norbert investigator.;
• Is Part Of: Journal of the American Heart Association. Volume 7:Issue 7(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-03-26
• Subjects: cardio‐vascular surgery -- ischemia/reperfusion injury -- remote ischemic preconditioning; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.117.008077
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : 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: NCT01067703.