ISC 2026 | Association of prehospital treatment duration with the efficacy of RIC in the RESIST trial

So the RESIST trial was a trial that was led out of Denmark and was published a few years ago, and it examined the efficacy of remote ischemic conditioning initiated in the ambulance for patients with suspected acute stroke. The trial was overall neutral, but what we were interested in with this particular study that was presented at ISC was seeing if the duration of therapy that people received before their arrival to the hospital made a difference in terms of the effectiveness of remote ischemic conditioning in that particular trial. The reason that’s important to look at is because for other neuroprotectants, for example, nerinetide, there’s been a strong indication that the duration to which the patient is exposed to that therapy before they receive a definitive stroke treatment like thrombolysis or thrombectomy makes a difference in terms of how much brain is saved and in turn for how well the patient ends up doing. And so we wondered if there might be a similar time-dependent, duration-dependent effect of remote ischemic conditioning. Unfortunately, we didn’t find any such association in this study. An important limitation in RESIST is that everyone was transported to the hospital reasonably quickly. Almost everyone arrived at the hospital within an hour of the transport being started. So our results may not apply to settings like Canada and other places where patients are routinely transported for several hours before they reach the hospital.

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