Remote preconditioning and major clinical complications following adult cardiovascular surgery: Systematic review and meta-analysis

被引：80

作者：

Healy, D. A. ^{[1
]}

Khan, W. A. ^{[1
]}

Wong, C. S. ^{[1
]}

Moloney, M. Clarke ^{[1
]}

Grace, P. A. ^{[1
]}

Coffey, J. C. ^{[1
]}

Dunne, C. ^{[1
]}

Walsh, S. R. ^{[2
]}

Sadat, U. ^{[3
]}

Gaunt, M. E. ^{[3
]}

Chen, S. ^{[4
]}

Tehrani, S. ^{[5
]}

Hausenloy, D. J. ^{[5
]}

Yellon, D. M. ^{[5
]}

Kramer, R. S. ^{[6
]}

Zimmerman, R. F. ^{[6
]}

Lomivorotov, V. V. ^{[7
]}

Shmyrev, V. A. ^{[7
]}

Ponomarev, D. N. ^{[7
]}

Rahman, I. A. ^{[8
]}

Mascaro, J. G. ^{[8
]}

Bonser, R. S. ^{[8
]}

Jeon, Y. ^{[9
]}

Hong, D. M. ^{[9
]}

Wagner, R. ^{[10
]}

Thielmann, M. ^{[11
]}

Heusch, G. ^{[11
]}

Zacharowski, K. ^{[12
]}

Meybohm, P. ^{[12
,13
]}

Bein, B. ^{[13
]}

Tang, T. Y. ^{[14
]}

机构：

[1] Univ Limerick, Limerick, Ireland

[2] Natl Univ Ireland Galway, Galway, Ireland

[3] Addenbrookes Hosp, Cambridge, England

[4] Cent South Univ, Hunan, Peoples R China

[5] UCL, Hatter Cardiovasc Inst, London WC1E 6BT, England

[6] Maine Med Ctr, Portland, ME USA

[7] Novosibirsk State Res Inst Circulat Pathol, Novosibirsk, Russia

[8] Queen Elizabeth Med Ctr, Birmingham, W Midlands, England

[9] Seoul Natl Univ Hosp, Seoul 110744, South Korea

[10] St Annes Univ Hosp, Brno, Czech Republic

[11] Univ Hosp Essen, Essen, Germany

[12] Univ Hosp Frankfurt, Frankfurt, Germany

[13] Univ Hosp Schleswig Holstein, Kiel, Germany

[14] Changi Gen Hosp, Singapore, Singapore

来源：

INTERNATIONAL JOURNAL OF CARDIOLOGY | 2014年 / 176卷 / 01期

关键词：

Cardioprotection; Cardiovascular surgery; Ischaemic preconditioning; Remote ischaemic preconditioning; Systematic review; BYPASS GRAFT-SURGERY; REDUCES MYOCARDIAL INJURY; CARDIAC-SURGERY; ANEURYSM REPAIR; DOUBLE-BLIND; PROTECTION; HEART; CARDIOPROTECTION; ISOFLURANE; MECHANISM;

D O I：

10.1016/j.ijcard.2014.06.018

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Background: A number of 'proof-of-concept' trials suggest that remote ischaemic preconditioning (RIPC) reduces surrogate markers of end-organ injury in patients undergoing major cardiovascular surgery. To date, few studies have involved hard clinical outcomes as primary end-points. Methods: Randomised clinical trials of RIPC in major adult cardiovascular surgery were identified by a systematic review of electronic abstract databases, conference proceedings and article reference lists. Clinical end-points were extracted from trial reports. In addition, trial principal investigators provided unpublished clinical outcome data. Results: In total, 23 trials of RIPC in 2200 patients undergoing major adult cardiovascular surgery were identified. RIPC did not have a significant effect on clinical end-points (death, peri-operative myocardial infarction (MI), renal failure, stroke, mesenteric ischaemia, hospital or critical care length of stay). Conclusion: Pooled data from pilot trials cannot confirm that RIPC has any significant effect on clinically relevant end-points. Heterogeneity in study inclusion and exclusion criteria and in the type of preconditioning stimulus limits the potential for extrapolation at present. An effort must be made to clarify the optimal preconditioning stimulus. Following this, large-scale trials in a range of patient populations are required to ascertain the role of this simple, cost-effective intervention in routine practice. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

引用

页码：20 / 31

页数：12

共 51 条

[1]

Ali N, 2010, JCPSP-J COLL PHYSICI, V20, P427, DOI 07.2010/JCPSP.427431

[2]

Remote ischemic preconditioning reduces myocardial and renal injury after elective abdominal aortic aneurysm repair - A randomized controlled trial [J].

Ali, Ziad A. ;

Callaghan, Chris J. ;

Lim, Eric ;

Ali, Ayyaz A. ;

Nouraei, S. A. Reza ;

Akthar, Asim M. ;

Boyle, Jonathan R. ;

Varty, Kevin ;

Kharbanda, Rajesh K. ;

Dutka, David P. ;

Gaunt, Michael E. .

CIRCULATION, 2007, 116 (11) :I98-I105

[3]

Alreja G, 2012, J INVASIVE CARDIOL, V24, P42

[4]

[Anonymous], 2013 ANN M SOC CARD

[5]

[Anonymous], CIRC J

[6]

[Anonymous], RENAL PROTECTION ISC

[7]

Remote Ischemic Conditioning to Protect against Ischemia-Reperfusion Injury: A Systematic Review and Meta-Analysis [J].

Brevoord, Daniel ;

Kranke, Peter ;

Kuijpers, Marijn ;

Weber, Nina ;

Hollmann, Markus ;

Preckel, Benedikt .

PLOS ONE, 2012, 7 (07)

[8]

USE OF SURVIVAL ANALYSIS TO DETERMINE THE CLINICAL-SIGNIFICANCE OF NEW Q-WAVES AFTER CORONARY-BYPASS SURGERY [J].

CHAITMAN, BR ;

ALDERMAN, EL ;

SHEFFIELD, LT ;

TONG, T ;

FISHER, L ;

MOCK, MB ;

WEINS, RD ;

KAISER, GC ;

ROITMAN, D ;

BERGER, R ;

GERSH, B ;

SCHAFF, H ;

BOURASSA, MG ;

KILLIP, T .

CIRCULATION, 1983, 67 (02) :302-309

[9]

Effect of remote ischemic preconditioning on renal dysfunction after complex valvular heart surgery: A randomized controlled trial [J].

Choi, Yong Seon ;

Shim, Jae Kwang ;

Kim, Jong Chan ;

Kang, Kyu-Sik ;

Seo, Yong Han ;

Ahn, Ki-Ryang ;

Kwak, Young Lan .

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2011, 142 (01) :148-154

[10]

Remote ischaemic preconditioning in coronary artery bypass surgery: a meta-analysis [J].

D'Ascenzo, Fabrizio ;

Cavallero, Erika ;

Moretti, Claudio ;

Omede, Pierluigi ;

Sciuto, Filippo ;

Rahman, Ishtiaq A. ;

Bonser, Robert S. ;

Yunseok, Jeon ;

Wagner, Robert ;

Freiberger, Tomas ;

Kunst, Gudrun ;

Marber, Michael S. ;

Thielmann, Matthias ;

Ji, Bingyang ;

Amr, Yasser M. ;

Modena, Maria Grazia ;

Zoccai, Giuseppe Biondi ;

Sheiban, Imad ;

Gaita, Fiorenzo .

HEART, 2012, 98 (17) :1267-1271

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