How Temporary Ischemia Reduces Later Harm

Btker has suggested the effectiveness of remote conditioning after onset of target-organ ischemia could also have implications for stroke treated with thrombolytics. Sepsis might be another area to investigate, as the changes seen there have some similarities to those of reperfusion injury.

For AMI, meanwhile, the time may be ripe for a U.S. prehospital trial.

“You’d have to have your IRB approve it, but I anticipate that’d be a pretty easy sell,” says Valenzuela. “The safety has been demonstrated over a lot of clinical studies. The hard part would be, when you start doing this in an EMS system, knowing you’re having a good effect in your community. It would take good collaboration with the emergency medicine docs and cardiologists.”

References

1. Btker HE, et al. Remote ischaemic conditioning before hospital admission, as a complement to angioplasty, and effect on myocardial salvage in patients with acute myocardial infarction: a randomised trial. Lancet 2010 Feb 27; 375(9,716): 727–34.

2. Kharbanda RK, Nielsen TT, Redington AN. Translation of remote ischaemic preconditioning into clinical practice. Lancet 2009 Oct 31; 374(9,700): 1,557–65.