Next Article in Journal
The Serum Cell-Free microRNA Expression Profile in MCTD, SLE, SSc, and RA Patients
Previous Article in Journal
Prognostic Abilities of Serial Neuron-Specific Enolase and Lactate and their Combination in Cardiac Arrest Survivors During Targeted Temperature Management
Previous Article in Special Issue
Prediction of One-Year Mortality Based upon A New Staged Mortality Risk Model in Patients with Aortic Stenosis Undergoing Transcatheter Valve Replacement
Open AccessArticle

Remote Ischemic Preconditioning Neither Improves Survival nor Reduces Myocardial or Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Implantation (TAVI)

1
Department of Internal Medicine and Cardiology, Herzzentrum Dresden at Technische Universität Dresden, 01307 Dresden, Germany
2
Center for Cardiology, Cardiology I, University Medical Center Mainz, 55131 Mainz, Germany
3
Department of Internal Medicine and Cardiology, HELIOS Klinikum Pirna, 01796 Pirna, Germany
4
Department of Cardiology, Klinikum Chemnitz, Technische Universität Dresden, 09116 Chemnitz, Germany
5
Department of Radiology, Universitätsklinikum Dresden, 01307 Dresden, Germany
6
Department of Internal Medicine and Cardiology, Charité—Universitätsmedizin Berlin, Campus Virchow-Klinikum, 13353 Berlin, Germany
7
Medical Faculty, Technische Universität Dresden, 01069 Dresden, Germany
8
Berlin Health Institute, 10178 Berlin, Germany
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
J. Clin. Med. 2020, 9(1), 160; https://doi.org/10.3390/jcm9010160
Received: 13 December 2019 / Accepted: 31 December 2019 / Published: 7 January 2020
Background: Peri-interventional myocardial injury occurs frequently during transcatheter aortic valve implantation (TAVI). We assessed the effect of remote ischemic preconditioning (RIPC) on myocardial injury, acute kidney injury (AKIN) and 6-month mortality in patients undergoing TAVI. Methods: We performed a prospective single-center controlled trial. Sixty-six patients treated with RIPC prior to TAVI were enrolled in the study and were matched to a control group by propensity-score. RIPC was applied to the upper extremity using a conventional tourniquet. Myocardial injury was assessed using high-sensitive troponin-T (hsTnT), and kidney injury was assessed using serum creatinine levels. Data were compared with the Wilcoxon-Rank and McNemar tests. Mortality was analysed with the log-rank test. Results: TAVI led to a significant rise of hsTnT across all patients (p < 0.001). No significant inter-group difference in maximum troponin release or areas-under-the-curve was detected. Medtronic CoreValve and Edwards Sapien valves showed similar peri-interventional troponin kinetics and patients receiving neither valve did benefit from RIPC. AKIN occurred in one RIPC patient and four non-RIPC patients (p = 0.250). No significant difference in 6-month mortality was observed. No adverse events related to RIPC were recorded. Conclusion: Our data do not show a beneficial role of RIPC in TAVI patients for cardio- or renoprotection, or improved survival. View Full-Text
Keywords: aortic valve stenosis; transcatheter aortic valve replacement; ischemic preconditioning; bioprosthesis aortic valve stenosis; transcatheter aortic valve replacement; ischemic preconditioning; bioprosthesis
Show Figures

Figure 1

MDPI and ACS Style

Flechsig, M.; Ruf, T.F.; Troeger, W.; Wiedemann, S.; Quick, S.; Ibrahim, K.; Pfluecke, C.; Youssef, A.; Sveric, K.M.; Winzer, R.; Heinzel, F.R.; Linke, A.; Strasser, R.H.; Zhang, K.; Heidrich, F.M. Remote Ischemic Preconditioning Neither Improves Survival nor Reduces Myocardial or Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Implantation (TAVI). J. Clin. Med. 2020, 9, 160.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop