Role of Ischemic Preconditioning in myocardial protection during CABG

Remote ischemic preconditioning (RIPC) is a biologic phenomenon in which a brief ischemia followed by reperfusion of an organ makes a distant organ more resistant against sustained ischemic insult. In order to assess whether RIPC can protect myocardium in CABG patients against ischemia, we conducted this study.Methods and materials: Elective coronary artery bypass grafting (CABG) patients were randomized to either receive RIPC (group A=145) or not (group B=145) after anesthesia. RIPC induction was by inflating a blood pressure cuff on the upper arm.The outcome was evaluated by comparison between serum troponin levels at various times after surgery. Mean serum troponin level at various times after surgery (6, 12, 24, 72 hours after the operation) in group A was significantly lower than group B (p<0.05). In addition decreasing trend of post operative serum troponin level was more significant in group A than group B (p<0.0001). RIPC can protect myocardium in CABG patients against ischemia and can be recommended for clinical use during open cardiac surgeries in order to decrease the incidence of myocardial ischemic injury following cardioplegic arrest.