Remote ischemic preconditioning: Current knowledge, unresolved questions, and future priorities

Karin Przyklenk, Peter Whittaker

Research output: Contribution to journalArticlepeer-review

109 Scopus citations


Remote ischemic preconditioning (RIPC) is the phenomenon whereby brief episodes of ischemia-reperfusion applied in distant tissues or organs render the myocardium resistant to a subsequent sustained episode of ischemia. Reduction of infarct size with RIPC has been documented in response to (i) brief antecedent ischemia in a remote coronary vascular bed (intra-cardiac protection); (ii) collection and transfer of coronary effluent from perconditioning "donor" hearts to naive "receptor" hearts (inter-cardiac protection); (iii) brief ischemia applied in skeletal muscle, mesentery, and other organs (interorgan protection); and (iv) remote nociception ("remote PC of trauma"). Moreover, the paradigm has expanded to encompass temporal modifications in the application of the remote stimulus (remote perconditioning and remote postconditioning). Progress has also been made in translating the concept of RIPC to patients undergoing planned ischemic events: evidence for attenuation of cardiac enzyme release with RIPC has been reported after elective abdominal aortic aneurysm repair, angioplasty, and coronary artery bypass graft surgery. However, despite these advances in characterization and clinical application, the mechanisms of RIPC-most notably, the means by which the protective stimulus is communicated to the heart-remain poorly defined and, in all likelihood, are model dependent.

Original languageEnglish
Pages (from-to)255-259
Number of pages5
JournalJournal of Cardiovascular Pharmacology and Therapeutics
Issue number3-4
StatePublished - Sep 2011


  • acute myocardial infarction
  • heart disease
  • ischemia-reperfusion injury
  • remote ischemic preconditioning


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