Table 6

Main Clinical Studies (Completed and Ongoing) Investigating Multitargeted Agents or Interventions Against AMI IRI in STEMI Patients Undergoing PPCI

First Author, Year (Trial) (Ref. #)No. of Patients (Control/Intervention)Multitargeted Treatment InterventionApproachPrimary EndpointOutcome
Completed studies
 Eitel et al., 2015 (LIPSIA-COND) (54)Control/IPost/RIPerC+IPost
232/232/232
Combined limb RIPerC + IPostRIPerC: In hospital upper limb
3 cycles (5/5 min, 200 mm Hg),
IPost: (1-min balloon inflation/1-min deflation) started as soon as possible after reopening of the culprit coronary artery
Myocardial salvage index (edema and late gadolinium enhancement by CMR)23% increase in salvage index
No limb RIPerC alone group
 Pasupathy et al., 2017 (NACIAM) (56)IV GTN/IV GTN+NAC
38/37
Combined NAC+GTNIV GTN:
IV NAC:
MI size (late gadolinium enhancement by CMR)5.5% reduction in infarct size
All patients received GTN
Actively recruiting studies
 Ovize et al., (CARIOCA) (NCT03155022)Estimated enrolment
355/355
Combined limb RIPerC and IPostRIC: In-hospital, upper limb,
4 cycles (5/5 min, 200 mm Hg) initiated as soon as possible before PCI
IPost: 4 cycles (1 min balloon inflation/1 min deflation) started as soon as possible after reopening of the culprit coronary artery
Combined incidence of all-cause mortality; worsening of heart failure during initial hospitalization or rehospitalization for heart failure at 6 months after PPCIRecruiting
 Garcia-Dorado et al., COMBAT-MI (NCT02404376)2 × 2 factorial design (RIC, exenatide, both, or neither)
107/107/107/107
Combined limb RIPerC+ exenatideRIC: in-hospital, upper limb,
4 cycles (5/5 min, 200 mm Hg)
Intravenous infusion of exenatide initiated before reperfusion
Myocardial infarct size (late gadolinium enhancement by CMR)Recruiting

CARIOCA = Combined Application of Remote and Intra-Coronary Ischemic Conditioning in Acute Myocardial Infarction; CMR = cardiac magnetic resonance; COMBAT-MI = COMBinAtion Therapy in Myocardial Infarction; GTN = nitroglycerin; IRI = ischemia–reperfusion injury; IV = intravenous; LIPSIA-COND = Effect of Conditioning on Myocardial Damage in STEMI; NAC = N-acetylcysteine; NACIAM = N-acetylcysteine in Acute Myocardial Infarction; PCI = percutaneous coronary intervention; PPCI = primary percutaneous coronary intervention; RIC = remote ischemic conditioning; STEMI = ST-segment elevation myocardial infarction; other abbreviations as in Tables 1 and 3.