REMOTE-CAT
Trial question
What is the effect of remote ischemic perconditioning in patients with AIS?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
38.0% female
62.0% male
N = 122
122 patients (46 female, 76 male).
Inclusion criteria: adult patients with AIS, pre-stroke mRS score < 3 and motor deficits.
Key exclusion criteria: unknown symptom onset; coma; pregnancy; malignancy or significant comorbidity thought to indicate life expectancy < 6 months.
Interventions
N=57 remote ischemic perconditioning (automated cuff placed on the unaffected arm in five 5-minute inflation-deflation cycles).
N=65 placebo (sham cuff that simulated the automated cuff device with the same sound and vibration).
Primary outcome
Modified Rankin Scale score < 3 at day 90
64.9%
47.7%
64.9 %
48.7 %
32.5 %
16.2 %
0.0 %
Remote ischemic
perconditioning
Placebo
Significant
increase ▲
NNT = 5
Significant increase in mRS score < 3 at day 90 (64.9% vs. 47.7%; OR 2.94, 95% CI 1.21 to 7.16).
Secondary outcomes
No significant difference in mRS score 0 at day 90 (14% vs. 9.2%; AD 4.8%, 95% CI -0.75 to 10.35).
No significant difference in reduction in NIHSS score ≥ 4 at day 5 (3.5% vs. 12.3%; RR 0.29, 95% CI -0.45 to 1.03).
Borderline significant decrease in stroke recurrence at day 90 (1.8% vs. 7.7%; RR 0.23, 95% CI -0.13 to 0.59).
Safety outcomes
No significant difference in non-symptomatic ICH.
Conclusion
In adult patients with AIS, pre-stroke mRS score < 3 and motor deficits, remote ischemic perconditioning was superior to placebo with respect to mRS score < 3 at day 90.
Reference
Francisco Purroy, Gloria Arqué, Xavier Jiménez-Fàbrega et al. Prehospital application of remote ischaemic perconditioning in acute ischaemic stroke patients in Catalonia: the REMOTE-CAT clinical trial. EClinicalMedicine. 2025:49:101592.
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