Remote ischemic preconditioning for coronary artery bypass graft operations

Ann Thorac Surg. 2013 Aug;96(2):727-36. doi: 10.1016/j.athoracsur.2013.02.049. Epub 2013 Jun 28.

Abstract

Ischemia-reperfusion injury occurs during coronary artery bypass graft operations. Strategies are needed to lower the extent of damage. Attempts to find these strategies have been occurring for more than 40 years, with remote ischemic preconditioning being one method. This review provides a look at potential mechanisms involved in remote ischemic preconditioning, experimental evidence supporting it, clinical studies that support and negate it, and potential reasons for differences between clinical studies. With remote ischemic preconditioning having the potential to better clinical outcomes in patients undergoing coronary artery bypass graft operations, a large clinical trial needs to be undertaken to better assess its practical clinical application.

Keywords: 17; AAR; ATP; AUC; BNP; CABG; CGRP; CK-MB; I; I/R; IPC; K(ATP); M; MAO; MAPK; NA; RISK; TnI; TnT; adenosine triphosphate; adenosine triphosphate-sensitive potassium; area at risk; area under the curve; brain natriuretic peptide; calcitonin gene-related peptide; coronary artery bypass graft; creatine kinase-MB; iNOS; inducible nitric oxide synthase; induction; ischemia-reperfusion; ischemic preconditioning; maintenance; mesenteric artery occlusion; mitogen-activated protein kinase; not applicable; rIPC; remote ischemic preconditioning; reperfusion injury signalling kinase; troponin I; troponin T.

Publication types

  • Review

MeSH terms

  • Clinical Trials as Topic
  • Coronary Artery Bypass / methods*
  • Humans
  • Ischemic Preconditioning / methods*