Clinical trial

BEtablocker Treatment After Acute Myocardial Infarction in Patients Without Reduced Left Ventricular Systolic Function (BETAMI)

Name
2018-000590-75
Description
The study aims to investigate whether oral betablocker (BB) therapy is superior to no such treatment following an acute myocardial infarction (AMI).
Trial arms
Trial start
2018-10-01
Estimated PCD
2024-12-10
Trial end
2034-12-10
Status
Active (not recruiting)
Phase
Early phase I
Treatment
Non-betablocker
No betablocker will be administered. Patients randomized to no beta-blockade will be discouraged to use beta-blockade as long as there is no other indication than strictly secondary prevention after myocardial infarction. Any other treatment or management is to be given as per usual care.
Arms:
Non-Betablocker
Betablocker
A betablocker will be administered. To reflect contemporary management, for which this study is designed to test, there will not be a defined minimum dosage. The type and dose of BB will be left at the discretion of the PI. Generic drug and accepted dosages will be: * Metoprolol succinate up to a total dose of 200mg daily * Bisoprolol up to a total dose of 10mg daily * Carvedilol up to a total dose of 50mg daily The treating physician will be encouraged to aim for an equipotent dose of 100 mg metoprolol succinate or higher. Any other treatment or management is to be given as per usual care.
Arms:
Betablocker
Size
2895
Primary endpoint
A composite of death of any cause, recurrent myocardial infarction, incident heart failure, coronary revascularization, ischemic stroke, malignant ventricular arrhythmia or resuscitated cardiac arrest
6 months (minimum) to 6 years (maximum)
Eligibility criteria
Inclusion Criteria To be eligible for inclusion in the study, subjects must fulfill the following criteria at inclusion: * 18 years or older * Diagnosed with an acute MI type I according to the "Universal Definition of MI" (Defined as a detection of a rise and/or fall of cardiac biomarker value, preferably troponin, with at least one value above the 99th percentile upper reference limit and with at least one of the following; a) symptoms of ischemia, b) new or presumed new significant ST-segment-T wave changes or new left bundle branch block, c) development of pathological Q waves, d) imaging evidence of new loss of viable myocardium or e) identification of an intracoronary thrombus by coronary angiogram) * Must have been treated with PCI or thrombolysis during current hospitalization * Signed informed consent and expected cooperation of the patient according to ICH/GCP and national/local regulations * Have a national personal identification number and not be expected to emigrate during study Exclusion Criteria Study subjects must not meet any of the following criteria: * Having a condition where betablocker-therapy is required, including but not limited to: * Arrhythmias * Hypertension * Cardiomyopathies * Clinical diagnosis of heart failure * LVEF \< 40% by echocardiography (by measurement and not only visual assessment for STEMI patients) * Left ventricular akinesia in ≥ 3 segments regardless of the LVEF * Contraindications to betablocker-therapy, including but not limited to: * Bradyarrhythmias * Hypotension * Severe peripheral artery disease * Previously known side-effects causing withdrawal * Severe chronic obstructive pulmonary disease * • Women of childbearing potential (a woman is considered of childbearing potential, i.e. fertile, following menarche and until becoming post-menopausal unless permanently sterile) * Known hypersensitivity to any ingredient of the IMP * Other, according to the responsible investigator * End-stage somatic disease with short life expectancy, dementia, psychosis and other conditions could put the subject at significant risk, confound the study results, interfere significantly with the subject participation in the study, or rendering informed consent unfeasible Previous treatment with a betablocker is not an exclusion criterion for enrollment into the BETAMI study. Enrolled patients can participate in any other study that does not directly alter the effect betablocker treatment
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE4'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'PARALLEL', 'interventionModelDescription': 'PROBE - prospective, randomized, open blinded end-point', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 2895, 'type': 'ACTUAL'}}
Updated at
2024-03-01

1 organization

1 product

3 indications