Long-term remote ischemic preconditioning after a heart attack

Effects of Long-term Remote Ischemic Preconditioning on Clinical Outcome in Patients With Acute Myocardial Infarction

This trial will test whether daily brief arm blood‑flow restriction after a recent heart attack can lower the chance of major heart and brain events over the following year for people treated for acute myocardial infarction.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 2146 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Henan Institute of Cardiovascular Epidemiology (other)
• Locations: 1 site (Zhengzhou, Henan)
• Trial ID: NCT07181356 on ClinicalTrials.gov

What this trial studies

This randomized trial will enroll about 2,146 patients with acute myocardial infarction and randomly assign 1,073 to daily upper‑limb remote ischemic preconditioning (RIPC) and 1,073 to usual care. RIPC consists of repeated brief cycles of arm blood‑flow restriction applied after admission and continued through follow‑up. Baseline labs, ECG, and ultrasound are recorded, and major adverse cardiovascular and cerebrovascular events (MACCE) and a composite PoCE endpoint are collected at 12 months, mainly by telephone follow‑up. The control arm receives standard medical management without the RIPC intervention.

Who should consider this trial

Good fit: Adults diagnosed with acute myocardial infarction by the Fourth Universal Definition who can tolerate upper‑limb RIPC and meet the study's inclusion/exclusion criteria are ideal candidates.

Not a fit: Patients with severe liver or renal dysfunction, uncontrolled severe hypertension, aortic or major coronary structural disease, those taking drugs that affect microcirculation (like nicorandil), pregnant people, or anyone who cannot tolerate RIPC are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, a simple, low‑cost daily RIPC protocol could reduce major cardiovascular and cerebrovascular events and improve one‑year outcomes after acute myocardial infarction.

How similar studies have performed: Prior short‑term RIPC studies around PCI have shown mixed results, and long‑term daily RIPC after AMI is relatively untested in large randomized trials.

Eligibility criteria

Inclusion Criteria:

* Patients with acute myocardial infarction were diagnosed in accordance with the criteria of the "Global Unified Definition of Fourth Myocardial Infarction"

Exclusion Criteria:

* The patients could not tolerate RIPC or RIPerC
* Aortic dissection, coronary artery aneurysm, coronary artery fistula and other systemic organic diseases
* The uncontrolled systolic blood pressure and diastolic blood pressure of severe hypertension were 180 mmHg and 120 mmHg respectively
* severe liver dysfunction (bilirubin \> 20 mmol / L, prothrombin time \> 2.0 ratio)
* Severe renal insufficiency (GFR \< 30 ml / min / 1.73 m2);
* patients taking nicorandil and other drugs affecting microcirculation
* pregnant

Where this trial is running

Zhengzhou, Henan

• Fuwai Central China Cardiovascular Hospital — Zhengzhou, Henan, China (RECRUITING)

Study contacts

• Study coordinator: Muwei LI

Conditions: Acute Myocardial Infarction