Khartoum

Researchers are evaluating whether Remote Ischaemic Conditioning (RIC) can reduce death and early heart failure within 30 days in patients with ST-segment elevation myocardial infarction (STEMI) in Africa. This trial focuses on higher-risk patients treated mainly with thrombolytic therapy, across about 25 sites in seven African countries. The study includes a randomized controlled trial (RCT) and an observational arm for patients presenting later than 24 hours but less than 72 hours after symptom onset. Patients in the RCT are randomly assigned to either RIC or a sham control. RIC involves four cycles of 5-minute inflation of a cuff on the upper arm to 20 mmHg above systolic blood pressure followed by 5 minutes of deflation, repeated daily for 3 days starting before thrombolysis. The sham control uses a similar device inflated to a low pressure of 20 mmHg for the same schedule. The observational arm includes patients presenting between 24 and 72 hours after symptom onset and follows the same outcome measures. Participants undergo assessments including ECG, biomarkers, and echocardiography to confirm STEMI and monitor outcomes. The primary measure is a combined rate of all-cause death and new heart failure at 30 days after STEMI. The study also monitors safety and collects informed consent, aiming to provide a low-cost, non-invasive therapy to improve outcomes for high-risk STEMI patients in Africa.