August 18, 2013
Remote Ischemic Preconditioning Could Limit Cardiac Damage Of Bypass Surgery
redOrbit Staff & Wire Reports - Your Universe Online
Using a blood pressure cuff on the upper arm of a patient just prior to heart bypass surgery could limit damage of the heart and improve long-term odds of survival, claims new research appearing in Saturday’s edition of The Lancet.
The practice is known as “remote ischemic preconditioning,” and according to HealthDay News it involves using the cuff to briefly cut off and then restore blood supply to the arm. Now, researchers working at a German hospital have shown that the practice could have benefits for patients preparing to undergo coronary artery bypass grafting (CABG).
Matthias Thielman and colleagues conducted a randomized study involving 329 patients scheduled for elective CABG surgery at the West-German Heart Center in Essen, Germany, Forbes contributor Larry Husten said. Of those patients, 162 underwent remote ischemic preconditioning prior to surgery, while a control group of 167 patients did not undergo the procedure before having their bypass.
Those in the treatment group underwent three cycles of ischemic preconditioning. Each cycle involved inflating a blood pressure cuff on the patients’ upper left arm for five minutes, followed by five-minutes of regular blood flow, Thielman said. Members of the preconditioning group were found to have significantly less cardiac damage in the first three days after the surgery than those in the control group, the Forbes writer added.
“Following surgery, the researchers measured the patients' blood concentrations of troponin I, a protein that indicates heart muscle damage,” HealthDay News explained. “Higher concentrations indicate more damage. Seventy-two hours after surgery, troponin levels were an average of 17 percent lower among patients who had remote ischemic conditioning than among those in the control group.”
The researchers followed the study participants for up to four years after CAGB in an attempt to determine whether or not the procedure had any impact on the long-term wellbeing of the patients. Twelve months following surgery, the patients who had remote ischemic preconditioning were 73 percent less likely than the control group to have died of any cause, and 86 percent less likely to have died from heart attack or stroke.
“The results of our study are very encouraging that remote ischemic preconditioning not only reduces heart muscle injury but also improves long-term health outcomes for heart bypass patients, and we hope that these benefits will be confirmed in larger prospective studies which are currently taking place” Gerd Heusch, the senior author of the study and a professor University School of Medicine Essen in Germany, said in a statement.