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The effect of repeated remote ischemic postconditioning on infarct size in patients with an ischemic stroke (REPOST): study protocol for a randomized clinical trial.

Landman, T, Schoon, Y, Warlé, M, De Leeuw, F-E and Thijssen, DHJ (2019) The effect of repeated remote ischemic postconditioning on infarct size in patients with an ischemic stroke (REPOST): study protocol for a randomized clinical trial. Trials, 20 (1). ISSN 1745-6215

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Open Access URL: http://dx.doi.org/10.1186/s13063-019-3264-0 (Published version)

Abstract

BACKGROUND: Remote ischemic postconditioning (rIPostC) refers to the observation that repeated, short periods of ischemia protect remote areas against tissue damage during and after prolonged ischemia. Based on previous observations of a potential neuroprotective effect of rIPostC, the aim of this study is to evaluate whether repeated rIPostC after an ischemic stroke can reduce infarct size, which could be translated to an improvement in clinical outcomes. METHODS/DESIGN: We will enroll 200 ischemic stroke patients to daily rIPostC or sham conditioning during hospitalization into a randomized single-blind placebo-controlled trial. The intervention consists of twice daily exposure to four cycles of 5-min cuff inflation around the upper arm to > 20 mmHg above systolic blood pressure (i.e., rIPostC) or 50 mmHg (i.e., control), followed by 5 minutes of deflation. The primary outcome is infarct size, measured using an MRI diffusion-weighted image at the end of hospitalization. Secondary outcomes include the Modified Rankin Scale, National Institutes of Health Stroke Scale, quality of life, and cardiovascular and cerebrovascular morbidity and mortality. To explore possible underlying mechanisms of rIPostC, venous blood will be sampled to assess biomarkers of inflammation and vascular health. DISCUSSION: Previous studies in animals and humans, using a single bout of remote ischemic conditioning, report a potential effect of rIPostC in attenuating neural damage. Although repeated rIPostC has been investigated for cardiovascular disease patients and preclinical stroke models, no previous study has explored the potential physiological and clinical effects of repeatedly applying rIPostC during the hospitalization phase after a stroke. TRIAL REGISTRATION: Netherlands Trial Register, NTR6880 . Registered on 8 December 2017.

Item Type: Article
Uncontrolled Keywords: 1102 Cardiorespiratory Medicine and Haematology, 1103 Clinical Sciences
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: BioMed Central
Related URLs:
Date Deposited: 01 Apr 2019 10:43
Last Modified: 01 Apr 2019 10:43
DOI or Identification number: 10.1186/s13063-019-3264-0
URI: http://researchonline.ljmu.ac.uk/id/eprint/10464

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