Remote ischaemic conditioning improves neurologic function in acute stroke

Treatment with remote ischaemic conditioning (RIC) in adults with acute moderate ischaemic stroke appears to increase the chances of achieving excellent neurologic function at 90 days as compared with usual care, as shown in the results of an open-label, blinded-endpoint, randomized clinical trial.

A total of 1,893 patients (mean age 65 years, 34.1 percent female) with acute moderate ischaemic stroke across 55 hospitals in China were randomized to receive RIC for 10 to 14 days as an adjunct to guideline-based treatment (n=922) or guideline-based treatment alone (n=971).

RIC was performed using a pneumatic electronic device, with treatment consisting of five cycles of cuff inflation for 5 minutes and deflation for another 5 minutes to the bilateral upper limbs to 200 mm Hg.

Of the patients, 1,776 (93.8 percent) completed the trial. The primary endpoint of excellent functional outcome at 90 days (modified Rankin Scale score 0 or 1) occurred in 582 (67.4 percent) in the RIC group and 566 (62.0 percent) in the control group (risk difference, 5.4 percent, 95 percent confidence interval [CI], 1.0–9.9; OR, 1.27, 95 percent CI, 1.05–1.54; p=0.02).

The proportion of patients who had any adverse events was 6.8 percent (59 out of 863) in the RIC group and 5.6 percent (51 out of 913).

Despite the encouraging results with RIC, researchers pointed out that the present data should be replicated in another trial to establish its efficacy.