{
  "abstract": "Objectives To evaluate the long-term efficacy of remote ischaemic postconditioning (RIPC) on functional outcomes in patients with acute ischaemic stroke (AIS) who received intravenous thrombolysis (IVT).Design This was a post-trial follow-up study of a rater-blinded randomised controlled trial.Setting Single-centre study conducted in a tertiary hospital in China, with follow-up interviews performed via telephone approximately 4.8 years after randomisation (November 2022).Participants The original trial ( NCT03218293) included 68 patients allocated either to the control group (n=34) or the RIPC group (n=32) between August 2017 and June 2018. For this follow-up, 62 patients (93.9%) were successfully contacted and included in the analysis.Primary and secondary outcomes The primary outcome was the proportion of patients achieving a favourable functional outcome, defined as a modified Ranking Score (mRS) 0 or 1 at long-term follow-up. Secondary outcomes included functional independence (mRS 0–2), recurrent stroke/transient ischaemic attack (TIA) and all-cause mortality. Binary outcomes were analysed using generalised linear models with inverse probability of treatment weighting (IPTW) adjustment. Time-to-event analyses employed IPTW-weighted Kaplan-Meier curves and Cox proportional hazards models, with statistical significance set at p<0.05.Results At a median follow-up of 4.8 years (IQR 4.6–5.1), the proportion of favourable functional outcome was higher in the RIPC group when compared with the control group (unadjusted risk ratio, 3.87; 95% CI 1.34 to 11.17; p=0.012 and IPTW-adjusted risk ratio, 5.92; 95% CI 1.45 to 24.24; p=0.017). The RIPC group also showed a trend towards improved stroke/TIA recurrence-free survival compared with the control group (IPTW-adjusted HR, 0.52; 95% CI 0.06 to 1.00; p=0.050).Conclusion IVT combined with repeated in-hospital RIPC may lead to improved long-term functional recovery and reduced stroke/TIA recurrence in patients with AIS. Larger multicentre trials are warranted to confirm these findings.Trial registration number NCT05614401.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China",
        "The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China"
      ],
      "name": "Jiaqi An"
    },
    {
      "affiliations": [
        "The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China"
      ],
      "name": "Meng Wei"
    },
    {
      "affiliations": [
        "Liverpool School of Tropical Medicine, Liverpool, UK"
      ],
      "name": "Duolao Wang"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China"
      ],
      "name": "Changying Zhao"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China"
      ],
      "name": "Xingyun Yuan"
    },
    {
      "affiliations": [
        "Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA"
      ],
      "name": "W Taylor Kimberly"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China"
      ],
      "name": "Guogang Luo"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China"
      ],
      "name": "Guoliang Li"
    }
  ],
  "title": "Long-term efficacy of remote ischaemic postconditioning after rt-PA intravenous thrombolysis in patients with acute ischaemic stroke",
  "uid": "f8595f59-34d7-5798-95c6-1f8cb0f3dc5b"
}