Myocardial Infarction Clinical Trial
Official title:
Effect of METOprolol in CARDioproteCtioN During an Acute Myocardial InfarCtion. The ME"Effect of METOprolol in CARDioproteCtioN During an Acute Myocardial InfarCtion" (METOCARD-CNIC): A Randomized, Controlled Parallel-group, Observer-blinded Clinical Trial of Early Pre-reperfusion Metoprolol Administration in ST-segment Elevation Myocardial infarctionTOCARD-CNIC Trial.
The purpose of this study is to test whether early pre-reperfusion metoprolol administration in patients suffering and acute myocardial infarction might reduce the size of myocardial necrosis.
Acute myocardial infarction (AMI) is a chief cause of death worldwide. The best strategy to
limit myocardial damage is to perform an early coronary reperfusion. However, despite
reperfusion, the size of infarctions is many times large. Infarct size has been recently
shown to be a strong predictor of future cardiovascular events and mortality. Therefore
interventions aimed at reducing infarct size are the matter of intense research; but despite
great efforts, no therapy has been shown to consistently limit infarct size.
ß-blockers are a class of drugs that have been used to treat cardiovascular conditions for
several decades. β-blockers reduce mortality when administered after an AMI, and are a class
IA indication in this context. What remains unclear is what timing and route of β-blocker
administration gives the maximum cardioprotective effect. In particular, whether early
β-blocker administration is able to reduce infarct size is a subject of debate. Recent
experimental data suggest that the β1 selective blocker metoprolol is able to limit the area
of necrosis only when administered before reperfusion.
The objective of this trial is to determine whether the administration of intravenous
pre-reperfusion metoprolol might reduce infarct size.
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