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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT03278509
Other study ID # EudraCT number 2017-002336-17
Secondary ID
Status Active, not recruiting
Phase Phase 4
First received
Last updated
Start date September 11, 2017
Est. completion date December 31, 2025

Study information

Verified date March 2024
Source Karolinska Institutet
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Long-term beta-blocker therapy has not been investigated in contemporary randomized clinical trials in patients with myocardial infarction and normal heart function. The aim of this study is to determine whether long-term treatment with oral beta-blockade in patients with myocardial infarction and preserved left ventricular systolic ejection fraction reduces the composite of death of any cause or new myocardial infarction..


Description:

REDUCE-SWEDEHEART is designed as a registry-based, randomized, parallel, open-label, multicenter trial. Patients, day 1-7 after myocardial infarction, who have undergone a coronary angiography and with preserved left ventricular systolic ejection fraction will be randomized to either oral beta-blockade (see "Intervention" for detailed description) at a dose according to the treating physician, or no beta-blockade. To allow quick inclusion the randomization module will be accessible by a simple web-based log-in procedure. Concomitantly, all baseline data about each individual patient will be collected from the SWEDEHEART registry. Patients will then be followed regarding all-cause mortality, myocardial infarction, heart failure, atrial fibrillation, and patient-related outcome measures (for a subgroup of patients). Patients that are eligible but not included in REDUCE-SWEDEHEART will also be followed regarding chosen treatment and the primary and secondary endpoints. Follow-up will continue until 379 primary endpoints have been observed (endpoint driven). All analyses will be performed on the intention-to-treat set, defined as all intentionally randomized patients, by randomized treatment. The primary endpoint is death or new MI. Information about death will be obtained from the Swedish population registry. Information regarding new myocardial infarction during hospitalization and readmission because of myocardial infarction or other outcome (secondary outcomes, see section below), will be obtained from the SWEDEHEART-registry (for myocardial infarction) and the patient registry of the National board of health and welfare.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 5000
Est. completion date December 31, 2025
Est. primary completion date November 16, 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: 1. Age=18 years. 2. Day 1-7 after MI as defined by the universal definition of MI, type 1, included in the SWEDEHEART registry. 3. Undergone coronary angiography during hospitalization. 4. Obstructive coronary artery disease documented by coronary angiography, i.e. stenosis = 50 %, FFR = 0.80 or iFR = 0.89 in any segment at any time point before randomization. 5. Echocardiography performed after the MI showing a normal ejection fraction (EF=50%). 6. Written informed consent obtained. Exclusion Criteria: 1. Any condition that may influence the patient's ability to comply with study protocol. 2. Contraindications for beta-blockade 3. Indication for beta-blockade other than as secondary prevention according to the treating physician.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Metoprolol Succinate
Eligible patients randomized to active treatment will receive long-term oral beta-blockade (metoprolol succinate or bisoprolol).
Bisoprolol
Please see the section above.

Locations

Country Name City State
Sweden Danderyd Hospital, Cardiac Intensive Care Danderyd Stockholms Län

Sponsors (3)

Lead Sponsor Collaborator
Karolinska Institutet The Swedish Research Council, Uppsala University

Country where clinical trial is conducted

Sweden, 

Outcome

Type Measure Description Time frame Safety issue
Other Anxiety and depression Anxiety and depression measured by Hospital Anxiety and Depression Scale (HADS) 8 weeks and 12 months after randomization
Other Wellbeing Wellbeing measured by WHO-5 Wellbeing Index 8 weeks and 12 months after randomization
Other Cardiac Anxiety Cardiac Anxiety measured by Cardiac Anxiety Questionnaire (CAQ) 8 weeks and 12 months after randomization
Other Sexual function Sexual function measured by Arizona Sexual Experiences Scale (ASEX) 8 weeks and 12 months after randomization
Primary Time to the composite of death of any cause or MI Time to the composite of death of any cause or MI on an intention to treat basis (ITT) through study completion, an average of 3 year
Secondary All-cause death Time to the individual component of the primary endpoint of any cause of death. through study completion, an average of 3 year
Secondary Myocardial infarction Time to the individual component of the primary endpoint of MI. through study completion, an average of 3 year
Secondary Cardiovascular death Time to cardiovascular death. through study completion, an average of 3 year
Secondary Heart failure Time to hospital readmission due to heart failure (primary [main] diagnosis) through study completion, an average of 3 year
Secondary Atrial fibrillation Time to hospital readmission due to atrial fibrillation (primary [main] diagnosis) through study completion, an average of 3 year
Secondary Bradycardia, Advanced AV-block, hypotension, syncope or need for pacemaker Time to hospital readmission due to bradycardia or advanced AV-block or hypotension or syncope or need for pacemaker (primary [main] diagnosis) through study completion, an average of 3 year
Secondary Asthma or Chronic Obstructive Pulmonary Disease Time to hospital readmission due to asthma or chronic obstructive pulmonary disease (primary [main] diagnosis) through study completion, an average of 3 year
Secondary Stroke Time to hospital readmission due to stroke (primary [main] diagnosis) through study completion, an average of 3 year
Secondary Health related quality of life (HRQOL) Health related quality of life (HRQOL) measured by EQ-5D in patients younger than 75 years of age Estimated maximal follow-up for each patient for this outcome is 1 year.
Secondary Health care costs Health care cost analysis concerning the use beta-blocker treatment through study completion, an average of 3 year
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