The efficacy of remote ischemic conditioning for outcomes in ischemic stroke patients with or without prior stroke: A post hoc analysis of the RICAMIS trial

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

European Journal of Neurology Pub Date : 2025-01-07 DOI:10.1111/ene.70032

Liang Liu, Xiao-Yu Sun, Chang Cui, Miao Liu, Yu Cui, Hui-Sheng Chen

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Abstract

Background and Purpose

To investigate the impact of a history of ischemic stroke or transient ischemic attack (TIA) on the effectiveness of remote ischemic conditioning (RIC) for outcomes in acute ischemic stroke patients.

Methods

We conducted a post hoc analysis of the Remote Ischaemic Conditioning for Acute Moderate Ischaemic Stroke (RICAMIS) trial. Patients in RICAMIS were categorized into two groups according to a history of stroke. The primary outcome was an excellent functional outcome, defined as a modified Rankin Scale (mRS) score of 0–1 at 90 days. Instead of comparing patients receiving usual care alone, we investigated the association of the RIC effect with functional outcomes in each group and the interaction between the RIC effect and a history of ischemic stroke or TIA.

Results

We included a total of 1695 patients, of whom 562 patients had a history of ischemic stroke or TIA and 1133 patients without prior ischemic stroke or TIA. In the Never Stroke or TIA group, a higher proportion of excellent functional outcomes was found in the RIC subgroup compared to the control subgroup (adjusted OR = 1.557 [95% CI 1.187–2.043], p = 0.001) but not in Prior Stroke or TIA group (adjusted OR = 1.299 [95% CI 0.893–1.888], p = 0.171). However, no significant interaction between the RIC effect and a history of ischemic stroke or TIA was found among the groups.

Conclusion

This is the first report suggesting that the RIC effect may be influenced by the history of ischemic stroke or TIA for patients with acute ischemic stroke.

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远程缺血适应对有或无卒中史的缺血性卒中患者预后的影响：一项对RICAMIS试验的事后分析

背景与目的：探讨缺血性卒中或短暂性脑缺血发作（TIA）史对急性缺血性卒中患者远程缺血适应（RIC）疗效的影响。方法：我们对急性中度缺血性卒中的远程缺血调节（RICAMIS）试验进行了事后分析。RICAMIS的患者根据卒中史分为两组。主要结局是良好的功能结局，定义为90天的修正Rankin量表（mRS）评分0-1。我们没有比较单独接受常规护理的患者，而是研究了RIC效应与每组功能结局的关系，以及RIC效应与缺血性卒中或TIA病史之间的相互作用。结果：我们共纳入1695例患者，其中562例患者有缺血性卒中或TIA病史，1133例患者无缺血性卒中或TIA病史。在从未卒中或TIA组中，RIC亚组的良好功能结局比例高于对照亚组（校正or = 1.557 [95% CI 1.187-2.043], p = 0.001），但在既往卒中或TIA组中没有（校正or = 1.299 [95% CI 0.893-1.888], p = 0.171）。然而，在组中没有发现RIC效应与缺血性卒中或TIA病史之间的显著相互作用。结论：这是首次报道急性缺血性脑卒中患者的RIC效果可能受到缺血性脑卒中或TIA病史的影响。

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来源期刊

European Journal of Neurology 医学-临床神经学

CiteScore

9.70

自引率

2.00%

发文量

418

审稿时长

1 months

期刊介绍： The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).