Remote ischemic conditioning combined with intravenous thrombolysis for acute ischemic stroke

OBJECTIVE: The objective of this study was to investigate the safety and efficacy of remote ischemic conditioning (RIC) combined with intravenous thrombolysis (IVT) in the treatment of acute ischemic stroke (AIS). METHODS: Patients with AIS who underwent IVT were enrolled and 1:1 randomized to the RIC group and sham‐RIC group in this study. RIC (or sham‐RIC) was performed twice within 6–24 h of IVT. The subjects in the two groups were followed up for 90 days. The safety outcome included the ratio of hemorrhagic transformation (HT), adverse events during the follow‐up, blood pressure within the first 24 h after IVT, and laboratory tests 24 h after IVT. The efficacy outcome included the modified Rankin Scale (mRS) score, National Institute of Health Stroke Scale (NIHSS) score during the follow‐up, and level of high‐sensitivity C‐reactive protein (hs‐CRP) tested 24 h after IVT. RESULTS: Forty‐nine patients (24 in the RIC group and 25 in the sham‐RIC group) were recruited. No significant difference was observed in the ratio of HT, adverse events, blood pressure, coagulation function or liver function between groups. In addition, there was no significant difference in mRS score and NIHSS score during the follow‐up between groups. However, patients in the RIC group exhibited a significant lower level of hs‐CRP compared with the control group (P = 0.048). INTERPRETATION: RIC combined with IVT is safe in the treatment of AIS. The neuroprotective and anti‐inflammatory effects of this therapy warrant further study on a larger scale.