[last updated 17/03/2014]

Recruitment Complete


1612 Patients Recruited

Effect of Remote Ischaemic preConditioning on clinical outcomes in patients undergoing Coronary Artery Bypass Graft surgery (ERICCA): A multicentre randomised controlled clinical trial.

Purpose of the trial:

To determine whether remote ischaemic preconditioning (RIC) improves clinical outcomes after cardiac surgery.

Primary objective:

To determine the effect of RIC on Major Adverse Cardiac and Cerebral Events (MACCE) 12 months after cardiac surgery. MACCE include cardiovascular (CV) death, myocardial infarction, revascularisation, and stroke.

Secondary objectives:

To determine the effects of RIC on:

  1. 30 day MACCE
  2. All cause death
  3. Peri-operative myocardial injury (Troponin T in the first 72 hours post-surgery)
  4. Peri-operative renal injury (creatinine and 24 hours serum  Neutrophil Gelatinase Associated Lipocalin (NGAL)) post-surgery
  5. Length of Intensive Therapy Unit (ITU) stay
  6. Inotrope score
  7. Hospital stay
  8. 6 minute walk test
  9. Quality of life
  10. Echo Substudy: Left ventricular ejection fraction
Patient Eligibility:

Inclusion criteria

  1. Patients undergoing CABG with or without valve surgery using blood cardioplegia
  2. Patients aged 18 years and above
  3. Patients with an additive Euroscore greater than or equal to 5

Exclusion criteria

  1. Cardiogenic shock*
  2. Cardiac arrest on current admission
  3. Pregnancy
  4. Significant peripheral arterial disease affecting the upper limbs
  5. Patients with significant hepatic dysfunction (INR>2)
  6. Patients with significant pulmonary disease (FEV1<40% predicted)
  7. Patients with known renal failure with a GFR<30 mL/min/1.73 m2
  8. Patients on glibenclamide or nicorandil, as these medications may interfere with RIC
  9. Patients recruited into another study which may impact on the ERICCA study

*Definition of cardiogenic shock:
Systolic blood pressure <90 mm Hg for 30 minutes before inotrope/vasopressor administration
Vasopressors or IABP are required to maintain systolic blood pressure >90 mm Hg