Limitations
CDA
This study has some limitations. First, it was a single-center RCT. Second, individual effects of each component of the CDA in decreasing IRI were not assessed separately. As the CDA specifically aims to achieve synergistic effects, the parallel testing of individual drugs was considered not useful and, in the clinical setting, extremely complex given the multitude of possible combinations. Third, despite the fact that CDA components were administrated according to a specific timing in relation to their pharmacokinetic data with the aim to reach a peak concentration during reperfusion, blood levels of each component were not determined. Fourth, although the study was powered to detect differences in peak AST, the small sample size did not allow a claim on the absence of an effect.