Remote Ischemic Conditioning With Local Ischemic Postconditioning in High-Risk ST-elevation Myocardial Infarction

Inclusion Criteria: * Acute chest pain lasting \<12 h * ST-elevation at the J-point in two contiguous leads of ≥2 mm in men ≥40 years, ≥2.5 mm in men \<40 years and ≥1.5 mm in women (regardless of age) in V2-V3 and/or ≥1 mm in all other leads (52). * New or presumed new left bundle branch block or right bundle branch block. * Killip class ≥II on hospital admission or requirement of diuretics because of clinical congestion. * Written informed consent. Exclusion Criteria: * Killip class I on hospital admission. * Prior fibrinolysis. * Conditions precluding use of RIC (i.e. paresis of the upper limb, presence of an arteriovenous shunt). * Pregnancy. * Age \<18 years. * Severe co-morbidity with a life expectancy \<6 months. * Participation in another trial.