Daily REmote Ischaemic Conditioning Following Acute Myocardial Infarction

The DREAM Study (Daily Remote Ischaemic Conditioning Following Acute Myocardial Infarction)

Remote ischaemic conditioning (RIC) is known to reduce infarct size post MI when used in the peri/immediate post infarct period. However little is known as to the effect of repeated remote conditioning post-MI (Myocardial Infarction) on not only infarct size, but also on ventricular remodeling and ultimately cardiac failure. In this phase II first in man trial, the investigators intend to carry out daily remote ischaemic conditioning in post MI patients. The principal hypothesis is that RIC applied on a daily basis for 4 weeks following a heart attack improves the ejection fraction at 4 months as assessed by cardiac magnetic resonance imaging.

Inclusion Criteria:

• LVEF < 45% on baseline ECHO
• First STEMI
• Successful revascularisation by PPCI
• Able to attend regional centre for follow-up appointment
• Competent to consent

Exclusion Criteria:

• < 18 of age
• ICD or CRTP/D in-situ
• Prior history of heart failure
• Haemoglobin < 11.5 g/dl
• Creatinine > 200 µmol/L (eGFR<30ml/min/m2)
• Known malignancy/other comorbid condition which in the opinion of the investigator is likely to have significant negative influence on life expectancy
• Significant complications/illness following MI
• Unable to undergo cMRI
• Further planned coronary interventions
• Enrollment in another clinical trial