Effect of Remote Ischemic Preconditioning on Myocardial Ischemia in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial
Wongthep A, MD¹, Karunasumetta C, MD¹, Tourthong W, MD¹, Senarak P, MD¹
Affiliation : ¹ Division of Cardiothoracic Surgery, Department of Surgery, Srinagarind Hospital and Queen Sirikit Heart Center of the Northeast, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective: To determine whether the remote ischemic pre-conditioning (RIPC) reduces myocardial ischemia in patients
undergoing elective coronary artery bypass graft (CABG) surgery.
Materials and Methods: The present study was a single-center, triple-blinded, randomized controlled trial. Fifty patients undergoing elective coronary artery bypass graft surgery were assigned to either RIPC or control treatment. Ischemic pre- conditioning consisted of three cycles of 5-minute of lower limb ischemia and reperfusion (cuff inflation and deflation) after anesthesia induction. Myocardial ischemia was assessed based on serum high-sensitivity cardiac troponin T (hs-cTnT).
Results: There was no significant difference in hs-cTnT levels between the RIPC group and the control group. Furthermore, there were no significant differences in inotropic drug use, acute kidney injury, mechanical ventilation time, hospital stay, or 30-day mortality. However, patients in the RIPC group had a significantly shorter length of stay in the intensive care unit (ICU).
Conclusion: Although RIPC did not reduce myocardial ischemia after CABG surgery, it did decrease the length of patients’ stays in the ICU.
Received 25 Sep 2019 | Revised 19 Nov 2019 | Accepted 20 Nov 2019
Keywords : Remote ischemic preconditioning, Coronary artery bypass graft, Myocardial ischemia, Troponin
