Department of Neurology General Hospital of Northern Theater Command Shenyang China.
Department of Oncology The First Affiliated Hospital of China Medical University Shenyang China.
J Am Heart Assoc. 2024 Apr 2;13(7):e033609. doi: 10.1161/JAHA.123.033609. Epub 2024 Mar 27.
Remote ischemic conditioning has been found to be effective in improving functional outcomes in acute ischemic stroke. We conducted a post hoc analysis of the RICAMIS (Remote Ischemic Conditioning for Acute Moderate Ischemic Stroke) trial to determine whether long-term remote ischemic conditioning duration after stroke onset is associated with better clinical outcomes in ischemic stroke.
Patients from the full analysis set were included in this secondary analysis. The primary outcome was the proportion of patients with an excellent functional outcome at 90 days, defined as a modified Rankin Scale score of 0 to 1. Among the 1776 patients, there were 55 patients in the 1 to 7 days remote ischemic conditioning group, 345 in the 8 to 10 days group, 412 in the 11 to 13 days group, 51 in the 14 to 16 days group, and 913 in the control group. Compared with the control group, a significantly higher proportion of excellent functional outcomes at 90 days was found in the 11 to 13 days remote ischemic conditioning group (adjusted absolute difference, 9.1% [95% CI, 3.7%-14.5%]; =0.001), which was attenuated in the other groups (adjusted absolute difference in the 8-10 days group, 2.0% [95% CI, -4.0% to 8.0%]; =0.51; adjusted absolute difference in the 14-16 days group, 7.4% [95% CI, -5.8% to 20.5%]; =0.27), but compared to the control group, there was lower proportion of excellent functional outcomes in the 1 to 7 days group (adjusted absolute difference, -14.4% [95% CI, -27.8% to 0.0%]; =0.05).
Among patients with acute moderate ischemic stroke, a higher likelihood of excellent clinical outcome was found in patients with longer duration of remote ischemic conditioning.
远程缺血预处理已被证明可有效改善急性缺血性脑卒中患者的功能预后。我们对 RICAMIS（急性中度缺血性脑卒中的远程缺血预处理）试验进行了事后分析，以确定脑卒中后远程缺血预处理的长期持续时间是否与缺血性脑卒中的更好临床结局相关。
本二次分析纳入了全分析集患者。主要结局为 90 天时具有良好功能结局的患者比例，定义为改良 Rankin 量表评分为 0 至 1 分。在 1776 例患者中，1 至 7 天远程缺血预处理组有 55 例，8 至 10 天组有 345 例，11 至 13 天组有 412 例，14 至 16 天组有 51 例，对照组有 913 例。与对照组相比，11 至 13 天远程缺血预处理组 90 天的良好功能结局比例显著更高（调整后的绝对差异为 9.1%[95%CI，3.7%-14.5%]；=0.001），而在其他组则减弱（8-10 天组调整后的绝对差异为 2.0%[95%CI，-4.0%至 8.0%]；=0.51；14-16 天组调整后的绝对差异为 7.4%[95%CI，-5.8%至 20.5%]；=0.27），但与对照组相比，1 至 7 天组的良好功能结局比例较低（调整后的绝对差异为-14.4%[95%CI，-27.8%至 0.0%]；=0.05）。
在急性中度缺血性脑卒中患者中，远程缺血预处理持续时间较长的患者临床结局良好的可能性更高。
