Late Post-Conditioning with XXXX after Cardiac Surgery--Are Surrogate Markers Associated with Clinical Outcome?

@entity1 @entity63 @entity2614 @entity1875 @entity299
INTRODUCTION: In a recent randomized controlled trial our group has demonstrated in 102 @entity1 that late post-conditioning with @entity2614 performed in the intensive care unit after surgery involving extracorporeal circulation reduced damage to cardiomyocytes exposed to @entity63 reperfusion injury. On the first post-operative day the @entity2614 @entity1 presented with lower troponin T values when compared with those undergoing @entity1875 sedation. In order to assess possible clinical relevant long-term implications in @entity1 enrolled in this study, we performed the current retrospective analysis focusing on cardiac and non- @entity299 during the first 6 months after surgery. METHODS: All @entity1 who had successfully completed the late post-conditioning trial were included into this follow-up. Our primary and secondary endpoints were the proportion of @entity1 experiencing cardiac and non- @entity299 , respectively. Additionally, we were interested in assessing therapeutic interventions such as initiation or change of drug therapy, interventional treatment or surgery. RESULTS: Of 102 @entity1 analyzed in the primary study 94 could be included in this follow-up. In the @entity2614 group (with 41 @entity1 ) 16 (39%) experienced one or several @entity299 within 6 months after cardiac surgery, in the @entity1875 group (with 53 @entity1 ) 19 (36%, p=0.75). Four @entity1 (9%) with @entity2614 vs. 7 (13%) with @entity1875 sedation had non- @entity299 (p=0.61). While a similar percentage of @entity1 suffered from @entity299 , only 12 @entity1 in the @entity2614 group compared to 20 @entity1875 @entity1 needed a therapeutic intervention (OR: 0.24, 95% CI: 0.04-1.43, p=0.12). A similar result was found for hospital admissions: 2 @entity1 in the @entity2614 group had to be re-admitted to the hospital compared to 8 in the @entity1875 group (OR 0.23, 95% CI: 0.04-1.29, p=0.10). CONCLUSIONS: @entity2614 does not seem to provide protection with regard to the occurrence of cardiac and non- @entity299 in the 6-month period following cardiac surgery with the use of extracorporeal circulation. However, there was a clear trend towards fewer interventions (less need for treatment, fewer hospital admissions) associated with @entity2614 post-conditioning in @entity1 experiencing any event. Such results might encourage launching large multicenter post-conditioning trials with clinical outcome defined as primary endpoint.
