Remote ischemic preconditioning and its role in the prevention of new onset atrial fibrillation post-cardiac surgery. A meta-analysis of randomized control trials.

Abstract

BackgroundThe denouement of remote ischemic preconditioning on new onset atrial fibrillation (NOAF) post‐cardiac surgery is not well‐established. An updated meta‐analysis of randomized control trials was performed by comparing remote ischemic preconditioning with controls and the outcome of interest was NOAF.MethodsThe systemic review was performed in accordance with the PRISMA (Preferred reporting items for systemic review) and AHA (American Heart Association) guidelines. PubMed database was searched to include relevant randomized control trials from inception to July 2019. We used Mantel‐Haenzsel method with random error model to calculate risk ratio (RR) with 95% confidence interval (CI). Heterogeneity was assessed using the I 2 test> 50% or χ 2 P < .05. Publication bias was visually assessed using a funnel plot.ResultsTwelve randomized control trials were included in the final analysis. Remote ischemic preconditioning did not alter the risk of NOAF post‐cardiac surgery [RR: 0.95, CI: 0.83‐1.09, P = .48, I 2 = 37%, χ 2 P = .09].ConclusionIn conclusion, the present meta‐analysis failed to provide any evidence for the beneficial effect of remote ischemic preconditioning in the prevention of NOAF.