Language:

Negative interaction between nitrates and remote ischemic preconditioning in patients undergoing cardiac surgery: the ERIC-GTN and ERICCA studies

Basic research in cardiology, 2022-12, Vol.117 (1), p.31-31, Article 31 [Peer Reviewed Journal]

The Author(s) 2022 ;2022. The Author(s). ;The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;ISSN: 0300-8428 ;EISSN: 1435-1803 ;DOI: 10.1007/s00395-022-00938-3 ;PMID: 35727392

Full text available

Citations Cited by

Actions
1. Add to My Research
2. Remove from My Research
3. E-mail
4. Print
5. Permalink
6. Citation
7. EasyBib
8. EndNote
9. RefWorks
10. Delicious
11. Export RIS
12. Export BibTeX

Title:
Negative interaction between nitrates and remote ischemic preconditioning in patients undergoing cardiac surgery: the ERIC-GTN and ERICCA studies
Author: Hamarneh, Ashraf ; Ho, Andrew Fu Wah ; Bulluck, Heerajnarain ; Sivaraman, Vivek ; Ricciardi, Federico ; Nicholas, Jennifer ; Shanahan, Hilary ; Hardman, Elizabeth A. ; Wicks, Peter ; Ramlall, Manish ; Chung, Robin ; McGowan, John ; Cordery, Roger ; Lawrence, David ; Clayton, Tim ; Kyle, Bonnie ; Xenou, Maria ; Ariti, Cono ; Yellon, Derek M. ; Hausenloy, Derek J.
Subjects: Blood pressure ; Calcium-binding protein ; Cardiac Surgical Procedures - adverse effects ; Cardiology ; Cardiovascular diseases ; Clinical outcomes ; Heart ; Heart attacks ; Heart surgery ; Humans ; Intravenous administration ; Intravenous infusion ; Ischemia ; Ischemic Preconditioning - adverse effects ; Ischemic Preconditioning, Myocardial ; Medicine ; Medicine & Public Health ; Mortality ; Myocardial infarction ; Myocardial Infarction - etiology ; Nitrates ; Original Contribution ; Patients ; Preconditioning ; Risk ; Surgery ; Treatment Outcome ; Troponin ; Troponin T
Is Part Of: Basic research in cardiology, 2022-12, Vol.117 (1), p.31-31, Article 31
Description: Remote ischaemic preconditioning (RIPC) using transient limb ischaemia failed to improve clinical outcomes following cardiac surgery and the reasons for this remain unclear. In the ERIC-GTN study, we evaluated whether concomitant nitrate therapy abrogated RIPC cardioprotection. We also undertook a post-hoc analysis of the ERICCA study, to investigate a potential negative interaction between RIPC and nitrates on clinical outcomes following cardiac surgery. In ERIC-GTN, 185 patients undergoing cardiac surgery were randomized to: (1) Control (no RIPC or nitrates); (2) RIPC alone; (3); Nitrates alone; and (4) RIPC + Nitrates. An intravenous infusion of nitrates (glyceryl trinitrate 1 mg/mL solution) was commenced on arrival at the operating theatre at a rate of 2–5 mL/h to maintain a mean arterial pressure between 60 and 70 mmHg and was stopped when the patient was taken off cardiopulmonary bypass. The primary endpoint was peri-operative myocardial injury (PMI) quantified by a 48-h area-under-the-curve high-sensitivity Troponin-T (48 h-AUC-hs-cTnT). In ERICCA, we analysed data for 1502 patients undergoing cardiac surgery to investigate for a potential negative interaction between RIPC and nitrates on clinical outcomes at 12-months. In ERIC-GTN, RIPC alone reduced 48 h-AUC-hs-cTnT by 37.1%, when compared to control (ratio of AUC 0.629 [95% CI 0.413–0.957], p = 0.031), and this cardioprotective effect was abrogated in the presence of nitrates. Treatment with nitrates alone did not reduce 48 h-AUC-hs-cTnT, when compared to control. In ERICCA there was a negative interaction between nitrate use and RIPC for all-cause and cardiovascular mortality at 12-months, and for risk of peri-operative myocardial infarction. RIPC alone reduced the risk of peri-operative myocardial infarction, compared to control, but no significant effect of RIPC was demonstrated for the other outcomes. When RIPC and nitrates were used together they had an adverse impact in patients undergoing cardiac surgery with the presence of nitrates abrogating RIPC-induced cardioprotection and increasing the risk of mortality at 12-months post-cardiac surgery in patients receiving RIPC.
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
Language: English
Identifier: ISSN: 0300-8428
EISSN: 1435-1803
DOI: 10.1007/s00395-022-00938-3
PMID: 35727392
Source: Springer Open Access
MEDLINE
ProQuest Central

Back to results list


INSPIRE LIBRARY - TON DUC THANG UNIVERSITY	(84-028) 37 755 057	Feedback
19 Nguyen Huu Tho St. Dist.7, HCM	thuvien@tdtu.edu.vn	Feedback

Negative interaction between nitrates and remote ischemic preconditioning in patients undergoing cardiac surgery: the ERIC-GTN and ERICCA studies

Searching Remote Databases, Please Wait