Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease (Apr 2018)
RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study: Myocardial Dysfunction, Postoperative Neurocognitive Dysfunction, and 1 Year Follow‐Up
- Patrick Meybohm,
- Madeline Kohlhaas,
- Christian Stoppe,
- Matthias Gruenewald,
- Jochen Renner,
- Berthold Bein,
- Martin Albrecht,
- Jochen Cremer,
- Mark Coburn,
- Gereon Schaelte,
- Andreas Boening,
- Bernd Niemann,
- Michael Sander,
- Jan Roesner,
- Frank Kletzin,
- Haitham Mutlak,
- Sabine Westphal,
- Rita Laufenberg‐Feldmann,
- Marion Ferner,
- Ivo F. Brandes,
- Martin Bauer,
- Sebastian N. Stehr,
- Andreas Kortgen,
- Maria Wittmann,
- Georg Baumgarten,
- Tanja Meyer‐Treschan,
- Peter Kienbaum,
- Matthias Heringlake,
- Julika Schoen,
- Sascha Treskatsch,
- Thorsten Smul,
- Ewa Wolwender,
- Thomas Schilling,
- Georg Fuernau,
- Holger Bogatsch,
- Oana Brosteanu,
- Dirk Hasenclever,
- Kai Zacharowski
Affiliations
- Patrick Meybohm
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany
- Madeline Kohlhaas
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany
- Christian Stoppe
- Department of Anesthesiology, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Matthias Gruenewald
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig‐Holstein, Germany
- Jochen Renner
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig‐Holstein, Germany
- Berthold Bein
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig‐Holstein, Germany
- Martin Albrecht
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig‐Holstein, Germany
- Jochen Cremer
- Department of Cardiovascular Surgery, University Hospital Schleswig‐Holstein, Germany
- Mark Coburn
- Department of Anesthesiology, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Gereon Schaelte
- Department of Anesthesiology, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Andreas Boening
- Department of Cardiovascular Surgery, University of Giessen, Germany
- Bernd Niemann
- Department of Cardiovascular Surgery, University of Giessen, Germany
- Michael Sander
- Department of Anesthesiology and Intensive Care, University of Giessen, Germany
- Jan Roesner
- Department of Anesthesiology and Intensive Care, Suedstadt Hospital Rostock, Germany
- Frank Kletzin
- Clinic of Anesthesiology and Intensive Care Medicine, University Hospital Rostock, Germany
- Haitham Mutlak
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany
- Sabine Westphal
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany
- Rita Laufenberg‐Feldmann
- Department of Anesthesiology, Medical Center of Johannes Gutenberg‐University, Mainz, Germany
- Marion Ferner
- Department of Anesthesiology, Medical Center of Johannes Gutenberg‐University, Mainz, Germany
- Ivo F. Brandes
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Goettingen, Germany
- Martin Bauer
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Goettingen, Germany
- Sebastian N. Stehr
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
- Andreas Kortgen
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
- Maria Wittmann
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Germany
- Georg Baumgarten
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Germany
- Tanja Meyer‐Treschan
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Duesseldorf, Germany
- Peter Kienbaum
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Duesseldorf, Germany
- Matthias Heringlake
- Department of Anesthesiology and Intensive Care Medicine, University Luebeck, Germany
- Julika Schoen
- Department of Anesthesiology and Intensive Care Medicine, University Luebeck, Germany
- Sascha Treskatsch
- Department of Anesthesiology and Intensive Care Medicine, Charité‐Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
- Thorsten Smul
- Department of Anesthesiology, University Hospital Wuerzburg, Germany
- Ewa Wolwender
- Department of Anesthesiology, University Hospital Wuerzburg, Germany
- Thomas Schilling
- Department of Anesthesiology, University Hospital Magdeburg, Germany
- Georg Fuernau
- University Heart Luebeck Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine) University Hospital Schleswig‐Holstein, Luebeck, Germany
- Holger Bogatsch
- Clinical Trial Centre, University Leipzig, Germany
- Oana Brosteanu
- Clinical Trial Centre, University Leipzig, Germany
- Dirk Hasenclever
- Institute for Medical Informatics, Statistics and Epidemiology, University Leipzig, Germany
- Kai Zacharowski
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany
- DOI
- https://doi.org/10.1161/JAHA.117.008077
- Journal volume & issue
-
Vol. 7,
no. 7
Abstract
BackgroundRemote 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 ResultsIn 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. ConclusionsSimilar 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 RegistrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT01067703.
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