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Induced Limb Ischemia May Reduce Post-CABG Injury

Serum troponin-T is lower in patients who undergo ischemia preconditioning prior to surgery

FRIDAY, Aug. 17 (HealthDay News) -- Patients scheduled for coronary artery bypass grafting (CABG) seem to have less post-surgical myocardial injury if they first undergo ischemic preconditioning in which the upper limb circulation is occluded in five-minute cycles, according to study findings published in the Aug. 18 issue of The Lancet.

Derek M. Yellon, D.Sc., of University College London Hospital in London, U.K., and colleagues conducted a study of 57 elective CABG patients, including 27 randomized to receive remote ischemic conditioning after anesthesia, consisting of three 5-minute cycles of right upper limb ischemia.

Concentrations of serum troponin-T were measured before surgery and after, at six, 12, 24, 48 and 72 hours. Remote ischemic preconditioning resulted in a significant reduction in overall serum troponin-T levels up to 48 hours after surgery.

Up to 50 percent of patients undergoing CABG surgery release troponins, a sign of myocardial injury, according to an editorial by Henry Purcell, Ph.D., and a colleague from the Royal Brompton Hospital in London. "If intermittent limb occlusions are consistently shown to reduce myocardial injury during cardiac revascularization, the implications for practice are immense," they write.

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