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Randomized controlled trial of remote ischemic preconditioning and atrial fibrillation in patients undergoing cardiac surgery

AIM: To study whether remote ischemic preconditioning (RIPC) has an impact on clinical outcomes, such as post-operative atrial fibrillation (POAF). METHODS: This was a prospective, single-center, single-blinded, randomized controlled study. One hundred and two patients were randomized to receive RIP...

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Autores principales: Lotfi, Amir S, Eftekhari, Hossein, Atreya, Auras R, Kashikar, Ananth, Sivalingam, Senthil K, Giannoni, Miguel, Visintainer, Paul, Engelman, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5088368/
https://www.ncbi.nlm.nih.gov/pubmed/27847563
http://dx.doi.org/10.4330/wjc.v8.i10.615
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author Lotfi, Amir S
Eftekhari, Hossein
Atreya, Auras R
Kashikar, Ananth
Sivalingam, Senthil K
Giannoni, Miguel
Visintainer, Paul
Engelman, Daniel
author_facet Lotfi, Amir S
Eftekhari, Hossein
Atreya, Auras R
Kashikar, Ananth
Sivalingam, Senthil K
Giannoni, Miguel
Visintainer, Paul
Engelman, Daniel
author_sort Lotfi, Amir S
collection PubMed
description AIM: To study whether remote ischemic preconditioning (RIPC) has an impact on clinical outcomes, such as post-operative atrial fibrillation (POAF). METHODS: This was a prospective, single-center, single-blinded, randomized controlled study. One hundred and two patients were randomized to receive RIPC (3 cycles of 5 min ischemia and 5 min reperfusion in the upper arm after induction of anesthesia) or no RIPC (control). Primary outcome was POAF lasting for five minutes or longer during the first seven days after surgery. Secondary outcomes included length of hospital stay, incidence of inpatient mortality, myocardial infarction, and stroke. RESULTS: POAF occurred at a rate of 54% in the RIPC group and 41.2% in the control group (P = 0.23). No statistically significant differences were noted in secondary outcomes between the two groups. CONCLUSION: This is the first study in the United States to suggest that RIPC does not reduce POAF in patients with elective or urgent cardiac surgery. There were no differences in adverse effects in either group. Further studies are required to assess the relationship between RIPC and POAF.
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spelling pubmed-50883682016-11-15 Randomized controlled trial of remote ischemic preconditioning and atrial fibrillation in patients undergoing cardiac surgery Lotfi, Amir S Eftekhari, Hossein Atreya, Auras R Kashikar, Ananth Sivalingam, Senthil K Giannoni, Miguel Visintainer, Paul Engelman, Daniel World J Cardiol Randomized Controlled Trial AIM: To study whether remote ischemic preconditioning (RIPC) has an impact on clinical outcomes, such as post-operative atrial fibrillation (POAF). METHODS: This was a prospective, single-center, single-blinded, randomized controlled study. One hundred and two patients were randomized to receive RIPC (3 cycles of 5 min ischemia and 5 min reperfusion in the upper arm after induction of anesthesia) or no RIPC (control). Primary outcome was POAF lasting for five minutes or longer during the first seven days after surgery. Secondary outcomes included length of hospital stay, incidence of inpatient mortality, myocardial infarction, and stroke. RESULTS: POAF occurred at a rate of 54% in the RIPC group and 41.2% in the control group (P = 0.23). No statistically significant differences were noted in secondary outcomes between the two groups. CONCLUSION: This is the first study in the United States to suggest that RIPC does not reduce POAF in patients with elective or urgent cardiac surgery. There were no differences in adverse effects in either group. Further studies are required to assess the relationship between RIPC and POAF. Baishideng Publishing Group Inc 2016-10-26 2016-10-26 /pmc/articles/PMC5088368/ /pubmed/27847563 http://dx.doi.org/10.4330/wjc.v8.i10.615 Text en ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Randomized Controlled Trial
Lotfi, Amir S
Eftekhari, Hossein
Atreya, Auras R
Kashikar, Ananth
Sivalingam, Senthil K
Giannoni, Miguel
Visintainer, Paul
Engelman, Daniel
Randomized controlled trial of remote ischemic preconditioning and atrial fibrillation in patients undergoing cardiac surgery
title Randomized controlled trial of remote ischemic preconditioning and atrial fibrillation in patients undergoing cardiac surgery
title_full Randomized controlled trial of remote ischemic preconditioning and atrial fibrillation in patients undergoing cardiac surgery
title_fullStr Randomized controlled trial of remote ischemic preconditioning and atrial fibrillation in patients undergoing cardiac surgery
title_full_unstemmed Randomized controlled trial of remote ischemic preconditioning and atrial fibrillation in patients undergoing cardiac surgery
title_short Randomized controlled trial of remote ischemic preconditioning and atrial fibrillation in patients undergoing cardiac surgery
title_sort randomized controlled trial of remote ischemic preconditioning and atrial fibrillation in patients undergoing cardiac surgery
topic Randomized Controlled Trial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5088368/
https://www.ncbi.nlm.nih.gov/pubmed/27847563
http://dx.doi.org/10.4330/wjc.v8.i10.615
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