Initiated in 2015, the ERIC-PPCI study was a multicentre, randomised double blind placebo controlled clinical trial investigating whether remote ischemic conditioning (RIC) can reduce cardiac death and hospitalization for heart failure at 12 months in patients presenting with a ST-elevation myocardial infarction (STEMI) and treated by percutaneous coronary intervention (PPCI). The study was undertaken in collaboration with the CONDI2 trial (Denmark, Serbia and Spain) and recruited 5401 patients in total, across 33 centres.
Importantly this landmark study has revealed the RIC procedure has a neutral outcome for the patients enrolled.
The Hatter Cardiovascular Institute has led the study from inception with Prof Derek Yellon and Prof Derek Hausenloy as Principal Investigators together with Prof Erik Bøtker from Denmark and Prof Raj Kharbanda from Oxford. This study represents a true translational investigation as the basic scientific research began in the laboratories of the Hatter Cardiovascular Institute, through to “proof of concept” at University College London Hospitals and finally resulting in this large scale, clinical study in man.
While the outcome has shown a neutral effect, this is a definitive answer to the question driving the study, the ultimate goal for all scientific research we undertake. From this result we are now able to formulate new hypotheses and look forward to understanding survival pathways and cellular mechanisms in humans. For example, the patients in the CONDI2/ERIC – PPCI study were from developed nations, namely the UK and Europe, typically on a regimen of medications which raise the threshold of protection alone. It may be that developing countries, with limited access to medical care and medications, are a more appropriate target for RIC in a STEMI setting. This outcome is important and discussions are already underway as to how to take this forward.
The PI’s of the study are grateful to all the patients who participated, the study team and the British Heart Foundation for their substantial support.
The full report of the study has been published in the Lancet, please read the paper HERE.