(2009). A secondary analysis of these two randomized trials revealed a postoperative decrease in the incidence

of acute kidney injury in nondiabetic preconditioned patients after CABG compared with controls (Venugopal et al. 2010). Thielmann et al. (2010) used the same preconditioning protocol in a single-blind, randomized clinical trial of 53 nondiabetic patients Inhibitors,research,lifescience,medical with triple-vessel disease who underwent CABG with crystalloid cardioplegic arrest. They found both a significant decrease in mean troponin T release (44.5%) and peak serum creatinine concentration postoperatively in the preconditioned group when compared with controls (Thielmann et al. 2010). Hong et al. (2010) found a 26% total reduction in postoperative troponin T in 65 patients preconditioned with four cycles of 5-min upper limb ischemia followed by reperfusion that underwent off-pump CABG, when compared with controls. Inhibitors,research,lifescience,medical However, this decrease did not reach statistical significance (Hong et al. 2010). In a single-blind, randomized clinical trial of 120 patients undergoing elective cardiac surgery (CABG, Inhibitors,research,lifescience,medical valve surgery, combined, or other), Zimmerman et

al. (2011) found that preconditioning (three cycles of 5-min limb ischemia followed by 5-min reperfusion) decreased the incidence of acute kidney injury within 48 h after surgery by 27%; even though a history of previous heart surgery – a known risk factor for acute kidney injury – was significantly more common in control patients compared with the preconditioned group. Using the aforementioned Inhibitors,research,lifescience,medical preconditioning stimulus in a larger, randomized clinical trial of 162 patients undergoing coronary artery bypass surgery, Rahman et al. (2010) found no correlation of RIPC with troponin release, blood hemodynamics, renal dysfunction, lung injury, or total hospital/ICU stay. However, it should be taken into consideration that patients with angina or with Inhibitors,research,lifescience,medical an acute coronary syndrome within 30 days of surgery were not excluded in this study protocol by Rahman et al. (2010). RIPC in clinical trials of patients undergoing percutaneous coronary intervention for acute myocardial infarction Table ​Table33

summarizes the design and results of five randomized clinical trials evaluating the safety and efficacy of RIPC in patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction. In a randomized clinical trial of others 41 consecutive patients with stable angina and single-vessel disease undergoing PCI and stent implantation, Iliodromitis et al. (2006) found that preconditioned patients with three cycles of 5-min upper limb ischemia followed by 5-min reperfusion had significantly higher troponin T and CK-MB Dactolisib chemical structure levels 24 h after the intervention, when compared with controls. Interestingly, a milder rise of cardiac enzymes was observed in the subgroup of preconditioned patients who were on statin treatment, suggesting that statins may ameliorate the inflammatory response after preconditioning (Iliodromitis et al. 2006).