Remote Ischemic Preconditioning for Renal and Cardiac Protection in Congestive Heart Failure (RICH) Trial (RICH)
Acute Kidney Injury, Heart Failure, Contrast Induced Nephropathy
About this trial
This is an interventional prevention trial for Acute Kidney Injury focused on measuring Contrast-induced acute kidney injury, Congestive heart failure, Contrast induced nephropathy, Coronary angiography, Percutaneous coronary intervention, Coronary artery disease, Remote ischemic conditioning, acute coronary syndrome, Acute kidney injury, Major adverse kidney events, Ischemic preconditioning
Eligibility Criteria
Inclusion Criteria:
- Age 18 years
- Diagnosis of heart failure with reduced LVEF <50%
- Pre-procedure intravenous normal saline fluid restriction status
- Society for Cardiovascular Angiography and Interventions (SCAI) AKI risk score (>1%)
- Referral for coronary angiogram and/or PCI
- Suspected stable coronary artery disease or acute coronary syndrome
Exclusion Criteria:
- Inability to give informed consent
- Unstable BP (SBP > 200 or <80 mmHg) at the time of enrolment
- Upper limb peripheral arterial disease
- Unavailability of at least one arm for RIPC/Sham-RIPC application
- Kidney transplant
- Renal disease requiring dialysis
- Prior exposure to contrast media within 72hrs preceding coronary angiography
- Pregnancy
- Prisoner
Sites / Locations
- VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PARecruiting
- Hunter Holmes McGuire VA Medical Center, Richmond, VA
Arms of the Study
Arm 1
Arm 2
Active Comparator
Sham Comparator
Remote ischemic preconditioning
Sham remote ischemic preconditioning
3 cycles of blood pressure cuff inflations to occlusive pressure of 200 mmHg for 5 minutes and deflation for 5 minutes
3 cycles of blood pressure cuff inflations to non-occlusive pressure of 60 mmHg for 5 minutes and deflation for 5 minutes (Control)