Tests remote ischaemic conditioning in heart attack patients across Africa
Tests a cuff-based heart protection device in adults with STEMI heart attacks.
Plain-language title generated from the registry record
Registry title: Remote Ischaemic Conditioning in STEMI Patients in AFRICA
Key facts
- Where
- Mombasa and Nairobi, KenyaSee the 4 sites
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults with a heart attack of the STEMI type who arrive within 24 hours of the start of the attack. Adults who arrive 24 to 72 hours after it can join a separate observation-only part.
- Age
- 18 years or older
- Sex
- All sexes
- Disease stage
- STEMI (a heart attack with ST-segment elevation on the ECG). For the randomised part: within 24 hours of the start of the heart attack. For the observation-only part: more than 24 hours and less than 72 hours after the start.
- Earlier treatment
- Patients who arrive within 12 hours are expected to receive thrombolytic (clot-dissolving) treatment. Patients who arrive between 12 and 24 hours are not given thrombolysis.
- Biomarker or test result
- Observation-only part: raised cardiac troponin (a heart injury blood marker) is one of the signs of a STEMI older than 24 hours.
Main reasons for not taking part
- Due to have primary percutaneous coronary intervention (a procedure to open the blocked artery)
- Cardiogenic shock or unstable blood pressure with signs of organ damage
- Conditions that make the arm cuff treatment unsafe, such as severe skin disease or burns on both arms, or amputation of both arms
- Expected to live less than 24 hours because of another illness
- Cannot have thrombolytic treatment (for those who arrive within 12 hours)
Read by machine on 12 November 2026.
Where in Kenya
- Coast General Teaching HospitalMombasa, KenyaContact: Keiran Mwazo, MBChBTaking people
- Mombasa HospitalMombasa, KenyaContact: Abdullah A Bajaber, MBChBTaking people
- Kenyatta National HospitalNairobi, KenyaContact: Elijah Ogola, PhDTaking people
- Nairobi West hospitalNairobi, KenyaContact: Elijah Elijah, PhDTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Contact the study team: see the registry record → Contacts and Locations
Print a page for my doctorTrial details
- Who runs it
- University of Cape Town
- Trial code
- NCT04813159
- Record updated
- 3 April 2025
- Original description
The RIC-AFRICA trial is a multi-centre, sham-controlled, randomised controlled trial (RCT) involving 1400 ST-segment elevation myocardial infarction (STEMI) patients presenting within ≤ 24 hours of myocardial infarction (MI) onset, across approximately 25 sites in 7 African countries (South Africa, Kenya, Sudan, Uganda, Mozambique, Senegal and Mauritius). Patients presenting with STEMI and deemed ineligible for the RIC AFRICA RCT because they present >24 hours from MI onset but less than 72 hours, will be recruited into the observational arm of the study with the same endpoints as the trial. The purpose of the RCT is to determine whether Remote Ischaemic Conditioning (RIC) can reduce the rates of all-cause death and early post-myocardial heart failure at 30-days in STEMI patients treated predominantly with thrombolytic therapy.Read full original descriptionShow less
Remote Ischaemic Conditioning in STEMI Patients in AFRICA: The RIC-AFRICA Trial
The RIC-AFRICA trial is a multi-centre, sham-controlled, randomised controlled trial (RCT) involving 1400 ST-segment elevation myocardial infarction (STEMI) patients presenting within ≤ 24 hours of myocardial infarction (MI) onset, across approximately 25 sites in 7 African countries (South Africa, Kenya, Sudan, Uganda, Mozambique, Senegal and Mauritius). Patients presenting with STEMI and deemed ineligible for the RIC AFRICA RCT because they present >24 hours from MI onset but less than 72 hours, will be recruited into the observational arm of the study with the same endpoints as the trial. The purpose of the RCT is to determine whether Remote Ischaemic Conditioning (RIC) can reduce the rates of all-cause death and early post-myocardial heart failure at 30-days in STEMI patients treated predominantly with thrombolytic therapy.
Inclusion: Adult patients (≥18 years old) presenting with suspected STEMI (ST-elevation at the J-point in two contiguous leads ( ≥ 0.2mV in men or ≥ 0.15mV in women in leads V2-V3 and/or ≥ 0.1mV in other lead); and II. Within 24 hours of onset of myocardial infarction as deemed by the attending clinician; and III. Signed informed consent; Signed informed consent; and; Clinical evidence of STEMI older than 24 hours and less than 72 hours as defined by:; Compatible history with maximal chest pain between 24 -72 hours prior to presentation; and; Compatible biomarkers (elevated cardiac troponin); and; ECG compatible with recent STEMI; and/or; Compatible echocardiography.
Exclusion: Contra-indication to thrombolytic therapy in patients presenting within guideline-recommended time (<12 hours); Observational arm of the study; Patients who are deemed ineligible for randomization into the trial on account of presentation beyond 24 hours, will be eligible for the observational arm of the study if the following inclusion/exclusion criteria are met; severe active skin disease/burns on both arms; or; breast cancer with lymph-node involvement on the ipsilateral side of RIC; or; Inter-current disease with an expected life expectancy of less than 24 hours; STEMI patients presenting with cardiogenic shock or haemodynamic instability as defined by: systolic blood pressure (SBP) measurement of <90 mm Hg for ≥30 minutes; or use of pharmacological and/or mechanical support to maintain SBP ≥ 90 mm Hg; and evidence of end-organ damage defined by: urine output of <30 mL/h; altered mental status; and/or serum lactate >2.0 mmol/L; STEMI patients due to undergo primary percutaneous coronary intervention; Contraindications for the use of RIC or sham-control on either arm such as:; bilateral upper limb amputations; or; evidence of acute limb ischaemia on either arm; or; active upper limb gangrene of any digits; bilateral arteriovenous fistulae needed for haemodialysis; Refusal or inability to sign informed consent.
We will be recruiting 3 different strata of STEMI patients; Adult patients (≥18 years old) presenting with STEMI receiving thrombolytic therapy within guideline-recommended time (i.e., within <12 hours of most severe chest pain onset); Adult patients (≥18 years old) presenting with STEMI who are ineligible for thrombolysis because they present outside of guideline-recommended time (<12 hours) but within 24 hours of most severe chest pain onset; Adult patients (≥18 years old) presenting with evidence of STEMI who do not receive thrombolysis and who present ≥24 hours and within 72 hours of most severe chest pain onset; Interventional arm of the Study: Randomized Control Trial; Patients who are deemed eligible for randomization into the trial on account of presentation with STEMI within 24 hours, will be eligible for the interventional arm of the study if the following inclusion/exclusion criteria are met.