Combination therapy with remote ischaemic conditioning and insulin or exenatide enhances infarct size limitation in pigs

Alburquerque-Béjar, Juan J.; Barba, Ignasi; Inserte, Javier; Miró-Casas, Elisabet; Ruiz‐Meana, Marisol; Poncelas, Marcos; Vilardosa, Úrsula; Valls-Lacalle, Laura; Rodríguez‐Sinovas, Antonio; Garcı́a-Dorado, David

doi:10.1093/cvr/cvv171

Cited by 50 publications

(36 citation statements)

References 39 publications

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“…For example, it has been suggested that propofol interferes with the development of RIC, 51 , 52 and it has been implicated as a potential reason for the apparent lack of translation of RIC 53 . Interestingly, we observed studies where propofol (together with either opioid analgesia ± pancuronium) was administered to have effect sizes above the mean 54 , 55 …”

Section: Discussionmentioning

confidence: 82%

Remote ischaemic conditioning reduces infarct size in animalin vivomodels of ischaemia-reperfusion injury: a systematic review and meta-analysis

et al. 2016

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AimsThe potential of remote ischaemic conditioning (RIC) to ameliorate myocardial ischaemia-reperfusion injury (IRI) remains controversial. We aimed to analyse the pre-clinical evidence base to ascertain the overall effect and variability of RIC in animal in vivo models of myocardial IRI. Furthermore, we aimed to investigate the impact of different study protocols on the protective utility of RIC in animal models and identify gaps in our understanding of this promising therapeutic strategy.Methods and resultsOur primary outcome measure was the difference in mean infarct size between RIC and control groups in in vivo models of myocardial IRI. A systematic review returned 31 reports, from which we made 22 controlled comparisons of remote ischaemic preconditioning (RIPreC) and 21 of remote ischaemic perconditioning and postconditioning (RIPerC/RIPostC) in a pooled random-effects meta-analysis. In total, our analysis includes data from 280 control animals and 373 animals subject to RIC. Overall, RIPreC reduced infarct size as a percentage of area at risk by 22.8% (95% CI 18.8–26.9%), when compared with untreated controls (P < 0.001). Similarly, RIPerC/RIPostC reduced infarct size by 22.2% (95% CI 17.1–25.3%; P < 0.001). Interestingly, we observed significant heterogeneity in effect size (T2 = 92.9% and I2 = 99.4%; P < 0.001) that could not be explained by any of the experimental variables analysed by meta-regression. However, few reports have systematically characterized RIC protocols, and few of the included in vivo studies satisfactorily met study quality requirements, particularly with respect to blinding and randomization.ConclusionsRIC significantly reduces infarct size in in vivo models of myocardial IRI. Heterogeneity between studies could not be explained by the experimental variables tested, but studies are limited in number and lack consistency in quality and study design. There is therefore a clear need for more well-performed in vivo studies with particular emphasis on detailed characterization of RIC protocols and investigating the potential impact of gender. Finally, more studies investigating the potential benefit of RIC in larger species are required before translation to humans.

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Section: Discussionmentioning

confidence: 82%

Remote ischaemic conditioning reduces infarct size in animalin vivomodels of ischaemia-reperfusion injury: a systematic review and meta-analysis

et al. 2016

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“…Alburquerque-Béjar et al . 130 found an additional 26% reduction in MI size when combining RIC with insulin-like therapies (such as GIK and exenatide) in a porcine acute MI model. The COMBinAtion Therapy in Myocardial Infarction (COMBAT-MI) study (NCT02404376) will investigate the potential benefits of combined reperfusion therapy using RIC with exenatide on MI size reduction in STEMI patients treated by PPCI.…”

Section: Optimizing Approaches To Cardioprotectionmentioning

confidence: 90%

Targeting reperfusion injury in patients with ST-segment elevation myocardial infarction: trials and tribulations

et al. 2016

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“…Firstly, spectra were digitized in 1000 bins of equal length so that all peaks in the spectra were taken into account. Once digitized, the spectra were fed into software package (SIMCA; Umetrics, Umea, Sweden) where unsupervised principal component analysis (PCA) and supervised orthogonal partial least squares discriminant analysis (OPLS‐DA) analysis were performed in order to discriminate between the groups …”

Section: Methodsmentioning

confidence: 99%

Cognitive and hedonic responses to meal ingestion correlate with changes in circulating metabolites

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Accarino

et al. 2016

Neurogastroenterology Motil

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Combination therapy with remote ischaemic conditioning and insulin or exenatide enhances infarct size limitation in pigs

Abstract: GIK and exenatide activate cardioprotective pathways different from those of RIC, and have additive effects with RIC on infarct size reduction in pigs.

Cited by 50 publications

References 39 publications

Remote ischaemic conditioning reduces infarct size in animalin vivomodels of ischaemia-reperfusion injury: a systematic review and meta-analysis

Remote ischaemic conditioning reduces infarct size in animalin vivomodels of ischaemia-reperfusion injury: a systematic review and meta-analysis

Targeting reperfusion injury in patients with ST-segment elevation myocardial infarction: trials and tribulations

Cognitive and hedonic responses to meal ingestion correlate with changes in circulating metabolites

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