Abstract WMP7: Comprehensive safety and efficacy analysis of the full remote ischemic perconditioning among acute ischemic stroke patients in Catalonia(REMOTECAT) study cohort

Background and objectives: Remote ischemic conditioning during cerebral ischemia ( PerRIC ) represents a new protection paradigm. We present the safety and efficacy analysis of the entire patient cohort of the multicenter double-blind REMOTECAT trial (. Methods: Patients with suspected stroke < 8 hours of evolution and motor RACE > 0 were included. The PerCI consisted of five inflation and deflation cycles of 5 minutes each, delivered using an AutoRIC device in the ambulance. The primary outcome was a modified Rankin Scale ( mRS ) score <=2 at 90 days. The safety variables were mortality at 3 months and neurological worsening (NE) at 24 hours and 5 days (NIHSS increase compared to baseline >4). Results: Between October 2022 and December 2023 and after an interruption of the study due to the COVID pandemic, a total of 200 patients from four university stroke centers were included: 41 (20.5%) with stroke mimics, 130 (65.0%) with ischemic stroke (IS), and 29 (14.5%) with hemorrhagic stroke (ICH). The mean age was 74.0 years while 78 [38.8%] were women. In only one patient, the application of RIC had to be stopped due to intense pain. Among the 159 patients with IS and ICH analyzed, 33 (20.8%) died. Neurological deterioration was observed in 19 patients (11.9%) at 24 hours and in 25 patients (15.7%) at 5 days. There were no differences between the PerRIC group and the sham group. After excluding 15 patients with a baseline mRS>2, the proportion of patients with a mRS<3 at 3 months was similar between the two groups (OR 1.40 [0.73-2.68]). Conclusions: PerRIC is safe but ineffective when considering together the cohort of patients with IS and ICH.