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Title: Remote Ischaemic Conditioning in STEMI Patients in Sub-Saharan AFRICA: Rationale and Study Design for the RIC-AFRICA Trial
Authors: Lukhna, Kishal
Hausenloy, Derek J. 
Ali, Abdelbagi Sidahmed
Bajaber, Abdullah
Calver, Alistair
Mutyaba, Arthur
Mohamed, Awad Abdalla
Kiggundu, Brian
Chishala, Chishala
Variava, Ebrahim
Elmakki, Ehab Ali
Ogola, Elijah
Hamid, Eltayeb
Okello, Emmy
Gaafar, Isam
Mwazo, Keiran
Makotoko, Makoali
Naidoo, Mergan
Abdelhameed, Mohamed Elhadi
Badri, Motasim
van der Schyff, Nasief
Abozaid, Omaima
Xafis, Paul
Giesz, Sara
Gould, Trevor
Welgemoed, Waldo
Walker, Malcolm
Ntsekhe, Mpiko
Yellon, Derek M.
Keywords: Cardioprotection
Hospitalization for heart failure
Ischaemia/reperfusion injury
Remote ischaemic conditioning
ST elevation myocardial infarction
Issue Date: 5-Nov-2021
Publisher: Springer
Citation: Lukhna, Kishal, Hausenloy, Derek J., Ali, Abdelbagi Sidahmed, Bajaber, Abdullah, Calver, Alistair, Mutyaba, Arthur, Mohamed, Awad Abdalla, Kiggundu, Brian, Chishala, Chishala, Variava, Ebrahim, Elmakki, Ehab Ali, Ogola, Elijah, Hamid, Eltayeb, Okello, Emmy, Gaafar, Isam, Mwazo, Keiran, Makotoko, Makoali, Naidoo, Mergan, Abdelhameed, Mohamed Elhadi, Badri, Motasim, van der Schyff, Nasief, Abozaid, Omaima, Xafis, Paul, Giesz, Sara, Gould, Trevor, Welgemoed, Waldo, Walker, Malcolm, Ntsekhe, Mpiko, Yellon, Derek M. (2021-11-05). Remote Ischaemic Conditioning in STEMI Patients in Sub-Saharan AFRICA: Rationale and Study Design for the RIC-AFRICA Trial. Cardiovascular Drugs and Therapy. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Purpose: Despite evidence of myocardial infarct size reduction in animal studies, remote ischaemic conditioning (RIC) failed to improve clinical outcomes in the large CONDI-2/ERIC-PPCI trial. Potential reasons include that the predominantly low-risk study participants all received timely optimal reperfusion therapy by primary percutaneous coronary intervention (PPCI). Whether RIC can improve clinical outcomes in higher-risk STEMI patients in environments with poor access to early reperfusion or PPCI will be investigated in the RIC-AFRICA trial. Methods: The RIC-AFRICA study is a sub-Saharan African multi-centre, randomized, double-blind, sham-controlled clinical trial designed to test the impact of RIC on the composite endpoint of 30-day mortality and heart failure in 1200 adult STEMI patients without access to PPCI. Randomized participants will be stratified by whether or not they receive thrombolytic therapy within 12 h or arrive outside the thrombolytic window (12–24 h). Participants will receive either RIC (four 5-min cycles of inflation [20 mmHg above systolic blood pressure] and deflation of an automated blood pressure cuff placed on the upper arm) or sham control (similar protocol but with low-pressure inflation of 20 mmHg and deflation) within 1 h of thrombolysis and applied daily for the next 2 days. STEMI patients arriving greater than 24 h after chest pain but within 72 h will be recruited to participate in a concurrently running independent observational arm. Conclusion: The RIC-AFRICA trial will determine whether RIC can reduce rates of death and heart failure in higher-risk sub-optimally reperfused STEMI patients, thereby providing a low-cost, non-invasive therapy for improving health outcomes. © 2021, The Author(s).
Source Title: Cardiovascular Drugs and Therapy
ISSN: 0920-3206
DOI: 10.1007/s10557-021-07283-y
Rights: Attribution 4.0 International
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