Remote Ischemic Conditioning on Infarct Growth in Patients With Acute Ischemic Stroke: Subgroup Analysis From the...

Area of Science:

• Neurology
• Cardiovascular Research
• Medical Imaging

Background:

• Remote ischemic conditioning (RIC) shows potential for cerebroprotection.
• Early infarct dynamics and the impact of RIC remain unclear.
• The RESIST substudy investigated RIC's effect on acute stroke infarct growth.

Purpose of the Study:

• To assess if RIC reduces acute-to-24-hour infarct growth using magnetic resonance imaging.
• To analyze infarct volume changes in patients receiving RIC versus a sham procedure.
• To determine the efficacy of RIC in limiting early brain damage after ischemic stroke.

Main Methods:

• Consecutive acute ischemic stroke patients from a single center were included.
• Infarct volumes were segmented using deep learning on diffusion-weighted MRI.
• Linear mixed-effects models analyzed infarct growth, accounting for group, time, and covariates.

Main Results:

• 346 patients (RIC=162, sham=184) were analyzed with similar baseline characteristics.
• Median infarct growth was comparable: RIC 0.45 mL vs. sham 0.40 mL.
• Mean infarct growth (RIC 6.19 mL vs. sham 5.80 mL) and subgroup analyses showed no significant group differences.

Conclusions:

• Combined prehospital and early in-hospital RIC did not alter early infarct growth compared to sham.
• No significant differences in infarct expansion were observed between RIC and sham groups.
• RIC was not associated with reduced early infarct growth in this acute stroke cohort.