• Journal of cardiology · Jan 2016

    Randomized Controlled Trial

    Remote ischemic preconditioning in aortic valve surgery: Results of a randomized controlled study.

    • Frédéric Pinaud, Jean-Jacques Corbeau, Christophe Baufreton, Jean-Patrice Binuani, Jean-Louis De Brux, Olivier Fouquet, Denis Angoulvant, Alain Furber, and Fabrice Prunier.
    • L'UNAM Université, France; CHU Angers, Service de Chirurgie Cardiaque, Angers, France; Université d'Angers, INSERM 1083, CNRS UMR 6214, Angers, France.
    • J Cardiol. 2016 Jan 1; 67 (1): 36-41.

    BackgroundAlthough remote ischemic preconditioning (RIPC) has emerged as an attractive strategy to reduce cardiac injury in patients undergoing diverse cardiac surgical procedures, it is unclear whether RIPC has protective effects in patients undergoing aortic valve replacement surgery without coronary artery bypass grafting (CABG).MethodsHence, 100 adult patients undergoing elective aortic valve replacement for aortic valve stenosis, without combined surgery with CABG, were prospectively randomly assigned in a 1:1 ratio to either the RIPC group or the control group. The RIPC group underwent three cycles of 5-min inflation to 200mmHg and 5-min deflation of an automated upper-arm cuff inflator after induction of anesthesia. The control group had a deflated cuff placed on upper arm for 30min. The primary endpoint was 72-h area under curve (AUC) for troponin I (cTnI). Secondary endpoints were 72-h AUC for creatine kinase-MB isoenzyme (CK-MB) release, incidence of acute kidney injury, extubation time, length of stay in intensive care unit, and simplified acute physiology score (SAPS II).ResultsThere were no significant differences in cTnI AUC [195±190 arbitrary units (a.u.) in RIPC group vs. 169±117 a.u. in the control group; p=0.41] and CK-MB AUC between groups. None of the other secondary endpoints differed between groups. Acute kidney injury occurred in 12 patients (24.5%) in the control group and in 13 (26.0%) in the RIPC group (p=0.86).ConclusionsRIPC did not exhibit significant cardiac or kidney protective effects in patients undergoing aortic valve replacement surgery without CABG.Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

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