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RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study: Myocardial Dysfunction, Postoperative Neurocognitive Dysfunction, and 1 Year Follow-Up.
- Source :
-
Journal of the American Heart Association [J Am Heart Assoc] 2018 Mar 26; Vol. 7 (7). Date of Electronic Publication: 2018 Mar 26. - Publication Year :
- 2018
-
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.<br />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.<br />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.<br />Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01067703.<br /> (© 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.)
- Subjects :
- Anesthetics, Intravenous adverse effects
Cardiac Surgical Procedures mortality
Double-Blind Method
Echocardiography, Transesophageal
Germany epidemiology
Humans
Incidence
Ischemic Preconditioning, Myocardial adverse effects
Ischemic Preconditioning, Myocardial mortality
Myocardial Infarction diagnostic imaging
Myocardial Infarction prevention & control
Myocardial Reperfusion Injury diagnostic imaging
Myocardial Reperfusion Injury prevention & control
Neurocognitive Disorders diagnosis
Neurocognitive Disorders prevention & control
Neurocognitive Disorders psychology
Neuropsychological Tests
Propofol adverse effects
Prospective Studies
Protective Factors
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Cardiac Surgical Procedures adverse effects
Cognition
Ischemic Preconditioning, Myocardial methods
Myocardial Infarction epidemiology
Myocardial Reperfusion Injury epidemiology
Neurocognitive Disorders epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 2047-9980
- Volume :
- 7
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of the American Heart Association
- Publication Type :
- Academic Journal
- Accession number :
- 29581218
- Full Text :
- https://doi.org/10.1161/JAHA.117.008077