Cardiovascular events in patients undergoing hip fracture surgery treated with remote ischaemic preconditioning: 1-year follow-up of a randomised clinical trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(18):9 Anaesthesia. 2021 Aug;76(8): 1042-1050What this means for my practice?
The results of this study found no significant reduction in major adverse cardiovascular events at 1 year with the performance of remote ischemic preconditioning in patients undergoing hip fracture surgery; however, a statistically significant reduction in the rate of myocardial infarction was observed. This study was not originally powered for a 1 year follow up period, which is a limitation of the study and may explain the lack of effect. More research on the long term effect of remote ischemic preconditioning on major cardiovascular events is required.
Study Summary
Six hundred and forty-eight patients undergoing a hip fracture surgery were randomized to receive remote ischemic preconditioning (n=316) or no treatment (n=309); this was a 1 year follow up study. The primary outcome of interest was the incidence of major adverse cardiovascular events. Secondary outcomes of interest included myocardial infarction, heart failure, stroke, non-fatal cardiac arrest, coronary revascularization procedure, clinically important arrhythmia, peripheral arterial thrombosis, cardiovascular rehospitalization, and all-cause mortality. Outcomes were assessed 1 year post-operation. No significant differences in all outcomes were observed between the two groups, with the exception of the rate of myocardial infarction which was significantly lower in the remote ischemic preconditioning group.
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