Effect of Remote Ischemic Preconditioning on Myocardial and Renal Injury: Meta-Analysis of Randomized Controlled Trials
- Volume 24 - Issue 2 - February 2012
- Posted on: 1/27/12
- 0 Comments
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Study limitations. Despite our best efforts and even after contacting the authors of abstracts published, we could not retrieve the data from 5 studies that had to be excluded from the final analysis. Two of these trials (totalling 68 patients) were published as abstracts and studied patients undergoing CABG,54,57 measured postoperative troponin release, and showed no benefits of RIPC. This could have biased our outcome. The study is limited by the lack of standard outcomes. Although we made every effort to unify the clinical outcomes by trying to obtain the data from the authors of original studies, we must concede that we had to accept the definition of clinical outcomes that was used by individual studies. We even tried to redefine these clinical outcomes by a common definition, but were limited due to lack of all of the original data used by the original studies.
RIPC constitutes an attractive means of ameliorating the adverse consequences of perioperative ischemia reperfusion injury in a range of clinical settings. It is easily performed, requires little additional equipment and may be highly cost effective. Our meta-analysis has demonstrated that RIPC appears to be associated with a favorable effect on the serological markers of myocardial and renal injury during cardiovascular interventions and reduced the incidence of periprocedural myocardial infarction. However, in view of the size and quality of currently published studies, and the inherent limitations of meta-analysis extracted from these studies, larger trials should be conducted to substantiate and quantify this initial impression. In conclusion, RIPC has great potential to improve patient outcomes, but further study is required to evaluate clinical endpoints.