Using remote ischemic preconditioning to protect kidneys and heart in heart failure patients

Remote Ischemic Preconditioning for Renal and Cardiac Protection in Congestive Heart Failure (RICH) Trial

Phase2; Phase3 Interventional VA Office of Research and Development · NCT04982419

This study is testing if a special treatment called remote ischemic preconditioning can help protect the kidneys and heart of heart failure patients during cardiac procedures.

Quick facts

PhasePhase2; Phase3
Study typeInterventional
Enrollment240 (estimated)
Ages18 Years and up
SexAll
SponsorVA Office of Research and Development Federal
Locations3 sites (Pittsburgh, Pennsylvania and 2 other locations)
Trial IDNCT04982419 on ClinicalTrials.gov

What this trial studies

The RICH Trial is a multicenter, randomized clinical trial designed to evaluate the effects of remote ischemic preconditioning on patients with congestive heart failure undergoing cardiac procedures. This study aims to assess its impact on contrast-associated acute kidney injury, functional capacity, and major adverse kidney events. Participants will be randomly assigned to receive either the remote ischemic preconditioning treatment or a sham procedure, with outcomes measured at one and three months post-procedure. The trial focuses on patients with reduced left ventricular ejection fraction and aims to provide insights into improving kidney and heart health during cardiac interventions.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older with heart failure and reduced left ventricular ejection fraction who are scheduled for coronary angiography or percutaneous coronary intervention.

Not a fit: Patients with unstable blood pressure, severe renal disease requiring dialysis, or those who cannot provide informed consent may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could significantly reduce the risk of acute kidney injury and improve overall outcomes for heart failure patients undergoing cardiac procedures.

How similar studies have performed: Previous studies on remote ischemic preconditioning have shown promising results, suggesting potential benefits in similar patient populations.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Age 18 years
* Diagnosis of heart failure with reduced LVEF \<50%
* Pre-procedure intravenous normal saline fluid restriction status
* Society for Cardiovascular Angiography and Interventions (SCAI) AKI risk score (\>1%)
* Referral for coronary angiogram and/or PCI
* Suspected stable coronary artery disease or acute coronary syndrome

Exclusion Criteria:

* Inability to give informed consent
* Unstable BP (SBP \> 200 or \<80 mmHg) at the time of enrolment
* Upper limb peripheral arterial disease
* Unavailability of at least one arm for RIPC/Sham-RIPC application
* Kidney transplant
* Renal disease requiring dialysis
* Prior exposure to contrast media within 72hrs preceding coronary angiography
* Pregnancy
* Prisoner

Where this trial is running

Pittsburgh, Pennsylvania and 2 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Acute Kidney InjuryHeart FailureContrast Induced NephropathyCoronary AngiographyPercutaneous Coronary InterventionContrast-induced acute kidney injuryCongestive heart failureContrast induced nephropathy
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.