Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Cardiovascular Surgery
Effects of Remote Ischemic Preconditioning With Postconditioning in Patients Undergoing Off-Pump Coronary Artery Bypass Surgery
– Randomized Controlled Trial –
Deok Man HongYunseok JeonChang-Soon LeeHyun Joo KimJung-Man LeeJae-Hyon BahkKi-Bong KimHo Young Hwang
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2012 Volume 76 Issue 4 Pages 884-890

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Abstract

Background: Myocardial injury is associated with an adverse outcome after off-pump coronary artery bypass graft surgery (OPCAB). The authors conducted a randomized controlled trial to evaluate whether remote ischemic preconditioning (RIPC) with remote ischemic postconditioning (RIPostC) reduces myocardial injury in patients undergoing OPCAB. Methods and Results: Seventy patients scheduled for OPCAB were randomly assigned to an RIPC+RIPostC group (n=35) or a control group (n=35). In the RIPC+RIPostC group, 4 cycles of 5-min ischemia and 5-min reperfusion were done on a lower limb before anastomoses (RIPC) and after anastomoses (RIPostC). RIPC+RIPostC significantly reduced postoperative serum troponin I levels (P=0.001). The area under the curve for postoperative troponin I was 48.7% lower in the RIPC+RIPostC group (median [interquartile range], 21.3h·ng-1·ml-1, 16.5-53.1h·ng-1·ml-1 vs. 41.5h·ng-1·ml-1, 24.6-90.2h·ng-1·ml-1, P=0.020). There was no significant difference in creatinine levels and PaO2/FiO2 ratios between the 2 groups. Conclusions: RIPC+RIPostC by lower limb ischemia decreased postoperative myocardial enzyme elevation by almost half postoperatively in patients undergoing OPCAB. (Circ J 2012; 76: 884-890)

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© 2012 THE JAPANESE CIRCULATION SOCIETY
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