Effect of remote ischemic preconditioning on fibrin formation and metabolism in patients undergoing hip fracture surgery: a randomized clinical trial.
Blood Coagul Fibrinolysis
; 33(1): 25-33, 2022 Jan 01.
Article
em En
| MEDLINE
| ID: mdl-34561340
ABSTRACT
Remote ischemic preconditioning (RIPC) prior to surgery has recently been shown to reduce the risk of myocardial injury and myocardial infarction after hip fracture surgery. This study investigated whether RIPC initiated antithrombotic mechanisms in patients undergoing hip fracture surgery. This trial was a predefined sub-study of a multicentre randomized clinical trial. Adult patients with cardiovascular risk factors undergoing hip fracture surgery between September 2015 and September 2017 were randomized 1ââ1 to RIPC or control. RIPC was initiated before surgery with a tourniquet applied to the upper arm and it consisted of four cycles of 5âmin of forearm ischemia followed by five minutes of reperfusion. The outcomes such as surgery-induced changes in thrombin generation, fibrinogen/fibrin turnover, tissue plasminogen activator, plasminogen activator inhibitor-1 and fibrin structure measurements were determined preoperatively (prior to RIPC) and 2âh postoperatively. One hundred and thirty-seven patients were randomized to RIPC (nâ=â65) or control (nâ=â72). There were no significant changes in thrombin generation, fibrinogen/fibrin turnover or fibrin structure measurements determined pre and postoperatively between patients in the RIPC and control groups. Subgroup analyses on patients not on anticoagulant therapy (nâ=â103), patients receiving warfarin (nâ=â17) and patients receiving direct oral anticoagulant therapy (nâ=â18) showed no significant changes between the RIPC-patients and controls. RIPC did not affect changes in thrombin generation, fibrin turnover or fibrin structure in adult patients undergoing hip fracture surgery suggesting that the cardiovascular effect of RIPC in hip fracture surgery is not related to alterations in fibrinogen/fibrin metabolism.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Precondicionamento Isquêmico
/
Infarto do Miocárdio
Tipo de estudo:
Clinical_trials
/
Risk_factors_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Blood Coagul Fibrinolysis
Ano de publicação:
2022
Tipo de documento:
Article