ObjectiveTo systematically review the efficacy of remote ischemic preconditioning in myocardial protection for on-pump CABG patients.
MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 1, 2015), WanFang Data, CBM and CNKI were searched from inception to January 2015 to collect randomized controlled trials (RCTs) about remote ischemic preconditioning on coronary artery bypass grafting under extracorporeal circulation. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted using RevMan 5.2 software.
ResultsA total of 11 RCTs involving 1 128 patients were included. The results of meta-analysis showed that, compared with patients in the control, the RIPC (remote ischemic preconditioning) patients had lower levels of troponin T (MD=-0.22, 95%CI -0.24 to -0.20, P < 0.000 01) and troponin I (MD=-1.91, 95%CI -2.43 to -1.38, P < 0.000 01). However, there were no statistical differences between the two groups in CK-MB, mortality at 30 days, inotropic support, length of stay in ICU or in hospital.
ConclusionCurrent evidence indicates that RIPC myocardial protection has little impact on patients undergoing CABG surgery. Due to the quantity and quality limitations of included studies, more high quality studies are needed to verify the above conclusion.
