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Remote Ischemic Conditioning for Acute Ischemic Stroke: The RICAIS Randomized Clinical Trial
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DOI：10.5551/jat.66105.png)
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Abstract
En 中文
Aims: Preclinical studies have shown that remote ischemic conditioning (RIC) has a neuroprotective effect; however, the findings of clinical studies are inconsistent. This study aimed to show the effect of RIC on acute ischemic stroke while considering its severity at baseline. Methods: We enrolled 79 patients with ischemic stroke who had National Institute of Health Stroke Scale (NIHSS) scores of 5-20 within 48 h after stroke onset and randomized them into the RIC [n = 43] and control groups [n = 36]. The intervention was performed using an inflatable cuff on one lower extremity. In the RIC group, each treatment consisted of four cycles of 5 min cuff inflation and deflation. The treatment was repeated once daily for at least three days. Based on the NIHSS score, the patients were divided into three groups: mild (NIHSS 5-9), moderate (NIHSS 10-14), and severe (NIHSS 15-20). The primary outcome was a good functional outcome at 90 days, defined as a modified Rankin Scale score of 0-1 in the mild group, 0-2 in the moderate group, and 0-3 in the severe group. Results: Among the 79 patients (mean age, 65.0 years, 40 women), 7 (16.3%) in the RIC group and 8 (22.2%) in the control group had good functional outcomes (odds ratio, 0.73 [95% confidence interval, 0.29-1.82]; P = 0.502). The incidences of major adverse cardiovascular events , aspiration pneumonia, and serious adverse events were similar in both the groups. Conclusion: Although this study may have been underpowered, RIC initiated within 48 h of stroke onset did not seem to improve the functional outcomes in acute ischemic stroke.
Keywords:
Remote ischemic conditioning
Ischemic stroke
Brain protection
Randomized controlled trial
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