{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T05:04:44Z","timestamp":1780031084205,"version":"3.53.1"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Elderly patients who experience acute myocardial infarction (AMI) in temporal proximity to transient ischemic attack (TIA) carry a high inflammatory burden and a disproportionate risk of recurrent cardio-cerebrovascular events. Remote ischemic preconditioning (RIPC) has been hypothesized to provide systemic protection through neurohumoral and immunomodulatory pathways, but clinical data in this dual-organ ischemia phenotype are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a single-center retrospective cohort study (2018\u20132023) of patients aged \u226560 years with AMI complicated by neurologist-adjudicated TIA. Patients received guideline-directed care with or without adjunctive RIPC per treating physician judgment. The RIPC protocol consisted of four cycles of 5-min brachial cuff inflation (200\u2005mm Hg or \u226520\u2005mm Hg above systolic pressure) and 5-min deflation, twice daily for 14 days, initiated within 24\u2005h when feasible. The primary endpoint was 12-month major adverse cardiac and cerebrovascular events (MACCE). Time-to-event analyses included Kaplan\u2013Meier estimates and Cox models; the multivariable model adjusted for age, sex, diabetes, left-ventricular ejection fraction (LVEF), log_e interleukin\u22126 (IL-6), high-sensitivity C-reactive protein (hs-CRP), and ACE-inhibitor therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 382 patients screened, 103 were analyzed (RIPC, 48; control, 55). Baseline characteristics were well balanced (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009\u2265\u20090.50). RIPC was initiated within 24\u2005h in 85.4% of treated patients; adherence averaged 86.0\u2009\u00b1\u200912.0% of planned cycles. At 12 months, MACCE occurred in 29.2% of RIPC patients and 49.1% of controls (log-rank\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.033). The unadjusted hazard ratio (HR) for MACCE with RIPC vs. control was 0.593 [95% confidence interval (CI), 0.367\u20130.958]; the multivariable Cox model yielded an adjusted HR of 0.725 (95% CI, 0.545\u20130.964;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.026). Component analyses were directionally concordant, with lower cumulative incidence of combined cardiac events [25.0% vs. 40.0%; unadjusted HR, 0.628 [95% CI, 0.402\u20130.981]; adjusted HR, 0.715 [95% CI, 0.506\u20131.011]] and combined cerebrovascular events [10.4% vs. 21.8%; unadjusted HR, 0.547 [95% CI, 0.308\u20130.972]; adjusted HR, 0.703 [95% CI, 0.491\u20131.007]]. In multivariable analyses, higher baseline IL-6 (per pg\/mL, HR, 1.032; 95% CI, 1.006\u20131.058;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.015) and hs-CRP (per mg\/L, HR, 1.026; 95% CI, 1.007\u20131.046;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.008) independently predicted MACCE, as did older age (per year, HR, 1.049; 95% CI, 1.009\u20131.091;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.017), and ACE-inhibitor therapy was associated with a lower risk of MACCE (HR, 0.714; 95% CI, 0.583\u20130.973;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.035). Subgroup analyses showed no significant treatment-by-subgroup interactions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In an elderly cohort with AMI complicated by TIA, adjunctive RIPC was associated with a lower 12-month risk of MACCE after adjustment for clinical and inflammatory covariates, with consistent directional benefits across cardiac and cerebrovascular components and a favorable safety\/adherence profile. Baseline IL-6 and hs-CRP were independent determinants of risk, and was consistent with an inflammation-linked pathobiology in which conditioning-based strategies warrant prospective evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1735859","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:45:09Z","timestamp":1780029909000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Remote ischemic preconditioning in elderly patients with acute myocardial infarction and transient ischemic attack: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Yunbo","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology","place":["Baotou, Inner Mongolia, China"]},{"name":"Department of Cardiology, Zhangjiakou First Hospital","place":["Zhangjiakou, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanjun","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology","place":["Baotou, Inner Mongolia, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zhangjiakou First Hospital","place":["Zhangjiakou, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology","place":["Baotou, Inner Mongolia, 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