Imperial College London
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MrStefanAntonowicz

Faculty of Medicine, Department of Surgery & Cancer

Clinical Senior Lecturer in Upper Gastro Surgery
 
 
 
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Contact

 

s.antonowicz Website

 
 
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Location

 

1st Floor B-BlockBlock B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Antonowicz:2018:10.1186/s12871-018-0524-6,
author = {Antonowicz, SS and Cavallaro, D and Jacques, N and Brown, A and Wiggins, T and Haddow, JB and Kapila, A and Coull, D and Walden, A},
doi = {10.1186/s12871-018-0524-6},
journal = {BMC Anesthesiology},
title = {Remote ischemic preconditioning for cardioprotection in elective inpatient abdominal surgery - a randomized controlled trial},
url = {http://dx.doi.org/10.1186/s12871-018-0524-6},
volume = {18},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Perioperative myocardial injury (PMI) is common in elective inpatient abdominal surgery and correlates with mortality risk. Simple measures for reducing PMI in this cohort are needed. This study evaluated whether remote ischemic preconditioning (RIPC) could reduce PMI in elective inpatient abdominal surgery. METHODS: This was a double-blind, sham-controlled trial with 1:1 parallel randomization. PMI was defined as any post-operative serum troponin T (hs-TNT) > 14 ng/L. Eighty-four participants were randomized to receiving RIPC (5 min of upper arm ischemia followed by 5 min reperfusion, for three cycles) or a sham-treatment immediately prior to surgery. The primary outcome was mean peak post-operative troponin in patients with PMI, and secondary outcomes included mean hs-TnT at individual timepoints, post-operative hs-TnT area under the curve (AUC), cardiovascular events and mortality. Predictors of PMI were also collected. Follow up was to 1 year. RESULTS: PMI was observed in 21% of participants. RIPC did not significantly influence the mean peak post-operative hs-TnT concentration in these patients (RIPC 25.65 ng/L [SD 9.33], sham-RIPC 23.91 [SD 13.2], mean difference 1.73 ng/L, 95% confidence interval - 9.7 to 13.1 ng/L, P = 0.753). The treatment did not influence any secondary outcome with the pre-determined definition of PMI. Redefining PMI as > 5 ng/L in line with recent data revealed a non-significant lower incidence in the RIPC cohort (68% vs 81%, P = 0.211), and significantly lower early hs-TnT release (12 h time-point, RIPC 5.5 ng/L [SD 5.5] vs sham 9.1 ng/L [SD 8.2], P = 0.03). CONCLUSIONS: RIPC did not at reduce the incidence or severity of PMI in these general surgical patients using pre-determined definitions. PMI is nonetheless common and effective cardioprotective strategies are required. TRIAL REGISTRATION: This tr
AU  - Antonowicz,SS
AU  - Cavallaro,D
AU  - Jacques,N
AU  - Brown,A
AU  - Wiggins,T
AU  - Haddow,JB
AU  - Kapila,A
AU  - Coull,D
AU  - Walden,A
DO  - 10.1186/s12871-018-0524-6
PY  - 2018///
SN  - 1471-2253
TI  - Remote ischemic preconditioning for cardioprotection in elective inpatient abdominal surgery - a randomized controlled trial
T2  - BMC Anesthesiology
UR  - http://dx.doi.org/10.1186/s12871-018-0524-6
UR  - https://www.ncbi.nlm.nih.gov/pubmed/29945555
UR  - http://hdl.handle.net/10044/1/78149
VL  - 18
ER  -
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