Wad Madani

The RIC-AFRICA trial is a multi-center, sham-controlled, randomized controlled trial involving 1400 patients who have experienced ST-segment elevation myocardial infarction STEMI within 24 hours of symptom onset. The study aims to find out if Remote Ischaemic Conditioning RIC can reduce death rates and early heart failure after a heart attack in patients mainly treated with clot-busting therapy. It also includes an observational group of patients presenting between 24 and 72 hours after the heart attack to study similar outcomes without treatment intervention. Participants are randomly assigned to either the RIC group or a sham control group. Those in the RIC group will receive four cycles of blood pressure cuff inflation to 20 mmHg above their systolic blood pressure for 5 minutes, followed by 5 minutes of deflation, repeated four times, and this protocol will be repeated daily for two more days. The sham group will undergo the same cycle with low-pressure inflation to 20 mmHg. The observational group, who present later, will not receive intervention but will be followed with the same outcome measures. Throughout the study, participants will be monitored for all-cause death and new onset heart failure within 30 days after the heart attack. Assessments will include clinical evaluations, ECG, biomarkers, and echocardiography to confirm STEMI and heart function. The study will also track major adverse cardiac and cerebrovascular events at 30 days. The total participation duration varies based on the group, with interventions over three days for the randomized groups and observation for up to 72 hours for the non-randomized group.