CRIC Combined With MFT for MFR in Patients With Incomplete Revascularization of CAD

Chronic Remote Ischemic Conditioning Combined With Mindfulness Therapy for Myocardial Flow Reserve in Patients With Incomplete Revascularization of Coronary Artery Disease: A Multicenter, Double-blind, Randomized Controlled Trial

The main objective of this study is to demonstrate whether the combination of chronic remote ischemic conditioning and mindfulness therapy can improve myocardial flow reserve in patients with incomplete revascularization of coronary artery disease.

Inclusion Criteria:

• Age ≥18 years old
• Consistent with the diagnosis of coronary heart disease, complete revascularization was not performed (coronary angiography showed that at least one vessel with a reference diameter of 3.0mm had stenosis greater than 90%, and quantitative flow ratio (QFR) < 0.80)
• Symptoms of myocardial ischemia (resting or exertional angina; Angina allele: chest tightness, shortness of breath, etc.);

Exclusion Criteria:

• • Age < 18 years old

  • Heart failure patients with NYHA class IV, or left ventricular ejection fraction (LVEF) < 30%
  • Creatinine clearance <15 mL/min (or eGFR < 15 mL/min/1.73m²), or requires dialysis
  • Myocardial diseases such as hypertrophic cardiomyopathy, dilated cardiomyopathy, etc.
  • Uncontrolled or recurrent arrhythmic events (e.g., ventricular fibrillation, recurrent or symptomatic sustained ventricular tachycardia, complete heart block, atrial fibrillation with rapid ventricular rates, supraventricular tachycardia refractory to drugs)
  • Poorly controlled hypertension (SBP > 180 mm Hg or DBP > 110 mm Hg)
  • Active liver disease or persistent ALT or AST elevation ≥ 3 times the upper limit of normal
  • Unexplained CK > 5 times the upper limit of normal, or elevated CK due to known muscle disease
  • Planned or anticipated cardiac surgery or revascularization before randomization
  • History of active malignancy (surgery, radiation therapy, and/or systemic therapy within the past 3 years)
  • Diagnosed or suspected upper extremity vascular malformations, aneurysms, arteriovenous fistulas, or thrombosis
  • Hearing impairment, unable to undergo mindfulness therapy
  • Currently participating in another drug or device study, or within 30 days of completing another drug or device study or receiving another investigational drug
  • Any life-threatening comorbid conditions expected to result in death within the next year (excluding cardiovascular diseases)
  • Alcoholism, substance abuse history; and unwilling or unable to stop alcohol or substance abuse during the study
  • History of major organ transplant (e.g., lung, liver, heart, bone marrow, kidney)
  • Investigator's judgment of known major active and uncontrolled disease, or any medical, physical, or surgical conditions (e.g., infection, significant blood, kidney, metabolic, gastrointestinal, or endocrine dysfunction) that may interfere with participation in the clinical study
  • As known to the investigator, the subject is unlikely to complete follow-up for more than 1 year or is expected to be unable to comply with the study requirements or understand the study's objectives and potential risks.