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Remote ischaemic conditioning for preventing and treating ischaemic stroke.
Wenbo Zhao1, Jing Zhang, Mordechai G Sadowsky
1Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China, 100053.
The Cochrane Database of Systematic Reviews
|July 6, 2018
Summary
Remote ischaemic conditioning (RIC) may reduce recurrent strokes in some patients but may increase death or dependence in acute stroke patients receiving thrombolysis. More research is needed due to low-quality evidence.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Remote ischaemic conditioning (RIC) is a neuroprotective strategy for ischaemic stroke.
- Preclinical studies suggest potential benefits, but clinical evidence is insufficient.
Purpose of the Study:
- To assess the benefits and harms of RIC for preventing and treating ischaemic stroke.
- To evaluate RIC in patients with ischaemic stroke and those at risk.
Main Methods:
- Included seven randomised controlled trials (RCTs) involving 735 participants.
- Analyzed effects of RIC on stroke prevention and treatment separately.
- Assessed risk of bias and used GRADE to evaluate evidence quality.
Main Results:
- RIC may reduce recurrent stroke in intracerebral artery stenosis and stroke severity in carotid stenting (low-quality evidence).
- RIC may increase death or dependence in acute ischaemic stroke patients receiving thrombolysis (low-quality evidence).
- Adverse events were higher with RIC, but no severe events were attributable to it.
Conclusions:
- Low-quality evidence suggests RIC may benefit specific stroke prevention scenarios.
- RIC might increase adverse outcomes in acute stroke treatment.
- Uncertainty remains due to small study numbers and low evidence quality.
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