In this multicenter trial, higher-risk adults undergoing on-pump CABG (with or without valve surgery) were randomly assigned to preconditioning with transient arm ischemia and reperfusion or sham conditioning. Remote ischemic preconditioning did not improve clinical outcomes. Coronary heart disease is the leading cause of death and disability worldwide. For patients with multivessel coronary artery disease, the treatment of choice for many is revascularization by means of coronary-artery bypass grafting (CABG) surgery. As a result of the aging of the population, an increased prevalence of coexisting conditions (e.g., diabetes, obesity, and hypertension), and a growing need for concomitant valve surgery, higher-risk patients are undergoing CABG surgery (with or without valve surgery); the clinical outcomes in such patients have been worse than the outcomes in patients without so many problems. 1 , 2 Thus, novel cardioprotective interventions are indicated to . . .