Remote Ischaemic Preconditioning Fails to Prevent Postoperative Myocardial Injury

Myocardial injury after noncardiac surgery (MINS) is a common complication defined by elevated cardiac troponin levels resulting from a presumed ischaemic mechanism, and it is independently associated with increased short-term and long-term mortality [1]. Remote ischaemic preconditioning (RIPC), a technique involving brief, non-lethal cycles of limb ischaemia and reperfusion to activate innate systemic cardioprotection, has been extensively studied as a low-cost intervention to mitigate this risk [2, 3]. While some trials in cardiac surgery have demonstrated reductions in perioperative myocardial injury and improvements in short-term clinical outcomes, results in the noncardiac setting remain largely inconsistent [4, 5, 6]. This discrepancy may stem from variations in anaesthetic regimens or the timing of the ischaemic stimulus relative to the surgical insult [4, 7]. A new randomized controlled trial now examines whether a two-session protocol can effectively reduce the incidence of MINS in patients undergoing major abdominal surgery.