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Safety and efficacy of remote ischemic postconditioning after thrombolysis in patients with stroke

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Mar 16, 2022 version files 42.81 KB

Abstract

Objective: To determine the effect of remote ischemic post-conditioning (RIPC) on acute ischemic stroke (AIS) patients undergoing intravenous thrombolysis (IVT).

Methods: A single-center, randomized controlled trial was performed with AIS patients receiving IVT. Patients in the RIPC group were administered RIPC treatment (after IVT) during hospitalization. The primary endpoint was a score of 0 or 1 on the modified Rankin scale (mRS) at day 90. The safety, tolerability and neuroprotection biomarkers associated with RIPC were also examined.

Results: We collected data from both RIPC (n=34) and controls (n=34). The average duration of hospitalization was 11.2 days. There was no significant difference between the two groups at admission for the NIHSS score (p=0.364) or occur to treatment time (p=0.889). An excellent recovery (mRS 0–1) at 3 months was obtained in 71.9% of the patients in the RIPC group vs 50.0% in the control group (adjusted risk ratio, 9.85; 95% CI, 1.54 to 63.16; P = 0.016). We further found significantly lower plasma S100 β (p=0.007) and higher vascular endothelial growth factor (p = 0.003) levels in the RIPC group than in controls.

Conclusions: Repeated RIPC combined with IVT can significantly facilitate recovery of nerve function and improve clinical prognosis of patients with AIS.