RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study: Myocardial Dysfunction, Postoperative Neurocognitive Dysfunction, and 1 Year Follow-Up

Autor: Meybohm, Patrick, Kohlhaas, Madeline, Boening, Andreas, Niemann, Bernd, Sander, Michael, Roesner, Jan, Kletzin, Frank, Mutlak, Haitham, Westphal, Sabine, Laufenberg-Feldmann, Rita, Ferner, Marion, Brandes, Ivo F., Stoppe, Christian, Bauer, Martin, Stehr, Sebastian N., Kortgen, Andreas, Wittmann, Maria, Baumgarten, Georg, Meyer-Treschan, Tanja, Kienbaum, Peter, Heringlake, Matthias, Schoen, Julika, Treskatsch, Sascha, Gruenewald, Matthias, Smul, Thorsten, Wolwender, Ewa, Schilling, Thomas, Fuernau, Georg, Bogatsch, Holger, Brosteanu, Oana, Hasenclever, Dirk, Zacharowski, Kai, RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study Collaborators, Stevanovic, Ana, Renner, Jochen, Rossaint, Rolf, Felzen, Marc, Goetzenich, Andreas, Moormann, Tobias, Chalk, Katharina, Knuefermann, Pascal, Recht, Thomas, Hoeft, Andreas, Winterhalter, Michael, Iken, Sonja, Bein, Berthold, Wiedenbeck, Carolin, Schwarzmann, Gerhard, Lindau, Simone, Zierer, Andreas, Fichtlscherer, Stephan, Goerlach, Gerold, Wollbrueck, Matthias, Boening, Ursula, Weigand, Markus, Strauchmann, Julia, Albrecht, Martin, Morsbach, Kai U., Paxian, Markus, Reinhard, Konrad, Scholz, Jens, Broch, Ole, Francksen, Helga, Kuhr, Bernd, Heinze, Hermann, Paarmann, Hauke, Cremer, Jochen, Sievers, Hans-Hinrich, Klotz, Stefan, Hachenberg, Thomas, Werner, Christian, Mauff, Susanne, Alms, Angela, Bergt, Stefan, Roewer, Norbert, Coburn, Mark, Schaelte, Gereon
Jazyk: angličtina
Rok vydání: 2018
Předmět:
medicine.medical_specialty
Time Factors
Myocardial Infarction
Neurocognitive Disorders
Myocardial Reperfusion Injury
Neuropsychological Tests
030204 cardiovascular system & hematology
ischemia/reperfusion injury
Risk Assessment
03 medical and health sciences
Cognition
0302 clinical medicine
Double-Blind Method
Risk Factors
Ischemia
Germany
Multicenter trial
Clinical Studies
Clinical endpoint
Humans
Medicine
Prospective Studies
030212 general & internal medicine
Myocardial infarction
Cardiac Surgical Procedures
Prospective cohort study
Propofol
Stroke
Original Research
Cardiovascular Surgery
cardio‐vascular surgery
business.industry
Incidence
Protective Factors
medicine.disease
Surgery
Cardiac surgery
Treatment Outcome
Ischemic Preconditioning
Myocardial
Ischemic preconditioning
remote ischemic preconditioning
Cardiology and Cardiovascular Medicine
business
Anesthetics
Intravenous
Echocardiography
Transesophageal
medicine.drug
Zdroj: Journal of the American Heart Association 7(7), (2018). doi:10.1161/JAHA.117.008077
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Popis: 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 . 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. 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. Clinical Trial Registration URL: https://www.clinicaltrials.gov . Unique identifier: NCT 01067703.
Databáze: OpenAIRE
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