• Patrick Meybohm, Madeline Kohlhaas, Christian Stoppe, Matthias Gruenewald, Jochen Renner, Berthold Bein, Martin Albrecht, Jochen Cremer, Mark Coburn, Gereon Schaelte, Andreas Boening, Bernd Niemann, Michael Sander, Jan Roesner, Frank Kletzin, Haitham Mutlak, Sabine Westphal, Rita Laufenberg-Feldmann, Marion Ferner, Ivo F Brandes, Martin Bauer, Sebastian N Stehr, Andreas Kortgen, Maria Wittmann, Georg Baumgarten, Tanja Meyer-Treschan, Peter Kienbaum, Matthias Heringlake, Julika Schoen, Sascha Treskatsch, Thorsten Smul, Ewa Wolwender, Thomas Schilling, Georg Fuernau, Holger Bogatsch, Oana Brosteanu, Dirk Hasenclever, Kai Zacharowski, and RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study Collaborators.
• Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany patrick.meybohm@kgu.de.
• J Am Heart Assoc. 2018 Mar 26; 7 (7).

BackgroundRemote 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 ResultsIn 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.ConclusionsSimilar 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 RegistrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT01067703.© 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

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