P55 Remote Ischaemic Preconditioning Reduces Cardiac Biomarkers During Vascular Surgery

Abstract

Objectives

The primary aim of this study was to evaluate the effects of remote ischaemic preconditioning (RIPC) on preventing the leakage of cardiac damage biomarkers in patients undergoing vascular surgery.

Methods

Randomised, sham-controlled, double-blinded, single-centre study has been carried out. In recruitment patients undergoing open abdominal aortic aneurysm repair, surgical lower limb revascularisation surgery or carotid endarterectomy were enrolled non-consecutively. The RIPC protocol consisting of 4 cycles of 5 minutes of ischaemia, followed by 5 minutes of reperfusion, was applied. A RIPC or a sham procedure was performed noninvasively at the same time as the patient was prepared for anaesthesia. High sensitivity troponin T level was measured preoperatively as well as 2, 8 and 24 hours after surgery and pro b-type natriuretic peptide was measured preoperatively and 24 hours after surgery.

Results

There was significantly higher leakage of high sensitivity troponin T (peak change median 2 ng/L, IQR 0.9–6.2 ng/L vs 0.6 ng/L, IQR 0.7–2.1 ng/L, p = 0.0002) and pro b-type natriuretic peptide (change median 144 pg/mL, IQR 17–318 pg/mL vs 51 pg/mL, IQR 12–196 pg/mL, p = 0.02) in the sham group compared to the RIPC group.

Conclusion

RIPC reduces the leakage of high sensitivity troponin T and pro b-type natriuretic peptide. Therefore, it may reduce cardiac damage in patients undergoing non-cardiac vascular surgery. The clinical significance of RIPC has to be evaluated in larger studies excluding the factors known to influence its effect.