04:21am Thursday 12 December 2019

International study finds novel SickKids-developed technique reduces the size of heart attacks by up to 50 per cent

 To view a video of Dr. Andrew Redington discussing the discovery, click here.

The medical device is a standard blood pressure cuff and the method, called remote ischemic preconditioning, has been shown to protect the heart during a heart attack. The study is published in the February 26 edition of The Lancet.

Dr. Andrew Redington, Division Head of Cardiology and Senior Associate Scientist at SickKids, and Professor in the Department of Paediatrics at the University of Toronto, led a transatlantic team of scientists from Aarhus, Denmark and Oxford, UK.

The randomized study looked at 333 Danish adult patients, who were having heart attacks. Half the patients received remote ischemic preconditioning in the ambulance on the way to the hospital.  The SickKids-developed preconditioning method consists of using a regular blood pressure cuff to transiently cut off blood flow to the arm; the cuff was inflated for five minutes, then deflated for five minutes, four times. At the hospital, the patients received routine heart attack treatment including angioplasty (a procedure to mechanically open narrowed or blocked blood vessels to the heart). Compared to the control group, the size of the heart attack was reduced by about 30 per cent overall in patients who were preconditioned. In patients having the largest heart attacks, the size was reduced by about 50 per cent.

“This is a good example of how research leads to clinical benefits,” says Redington. “Remote ischemic preconditioning could be one of the most effective treatments for evolving heart attacks that we have. While it’s too early to say whether this will be applicable in all cases, these results are extremely promising.”

Ischemic preconditioning is a powerful innate mechanism the body uses to protect all its tissues – not only the heart – from the effects of lack of blood flow. While this is not a new phenomenon, it was Redington and Dr. Rajesh Kharbanda from the UK, who developed the method to harness this natural mechanism in 2001. They found that reducing the blood flow in the arm sends a warning message to the body and the heart, by releasing substances in the blood that protect the body and the heart from subsequent injury.

In the first human study performed at SickKids and reported in 2006, Redington showed that preconditioning also helps to reduce heart damage in children undergoing heart surgery. Others have shown this to also be true in adults undergoing cardiac and vascular surgery, and elective coronary angioplasty.

The current study evolved from previous research performed by the international team, where the preconditioning was performed prior to the procedure. In 2007, the researchers showed that preconditioning during a heart attack may have similar benefits in lab animals. This led to the current study in humans, showing dramatic results.

“This is just the beginning – we would like to see more studies with larger groups of patients,” says Redington. “While the reduced heart attack is an important benefit, we would like to determine whether this will lead to improved survival rates, patient well-being and quality of life.”

Redington and colleagues are also working on developing an automated cuff that would make it easier and more efficient for health-care workers to use. SickKids has licensed intellectual property and is working with a Canadian company to develop the product.

This research was supported by Fondation Leducq and SickKids Foundation.  

The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally.  Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system.  SickKids is proud of its vision of Healthier Children. A Better World.™ For more information, please visit www.sickkids.ca.

For more information, please contact:

Matet Nebres
Manager, Media Relations
Communications and Public Affairs
The Hospital for Sick Children
Tel: 416-813-6380
Fax: 416-813-5328
e-mail: matet.nebres@sickkids.ca

Suzanne Gold
Communications Specialist – Media Relations
Communications and Public Affairs
The Hospital for Sick Children
Tel: 416-813-7654 ext. 2059
Fax: 416-813-5328
e-mail: suzanne.gold@sickkids.ca

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