De-prescribe beta blocker therapy for Myocardial Infarction
This study is evaluating whether beta-blockers are beneficial in patients with coronary artery disease who are not at high risk for heart failure or atrial fibrillation.
See full descriptionAbout the trial for Myocardial Infarction
Treatment Groups
This trial involves 2 different treatments. De-prescribe Beta Blocker Therapy is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are in Phase 4 and have been shown to be safe and effective in humans.
Eligibility
This trial is for patients born any sex aged 18 and older. You must have received 1 prior treatment for Myocardial Infarction or one of the other 8 conditions listed above. There are 4 eligibility criteria to participate in this trial as listed below.
Approximate Timelines
Measurement Requirements
This trial is evaluating whether De-prescribe beta blocker therapy will improve 7 primary outcomes and 3 secondary outcomes in patients with Myocardial Infarction. Measurement will happen over the course of 3 years.
Who is running the study
Principal InvestigatorPatient Q & A Section
What causes myocardial infarction?
The main risk factors for developing an MI and their consequences remain high-grade and low-grade dyslipidaemia, hypertension, smoking, obesity, excess alcohol, diabetes mellitus, and family history of cardiovascular diseases. There is growing concern that the risk of MI is increasing in men and women of Caucasian descent living in developing rather than developed countries. The mechanisms by which this increase occurs remains unclear. Nevertheless, preventive programmes aimed at treating and preventing the risk factors that are associated with an increased risk of developing an MI (notably diabetes mellitus) as well as preventing cardiovascular diseases are urgently needed.
What are common treatments for myocardial infarction?
In a recent study, findings of this study showed the use of several commonly used treatments in the acute care of MI patients including the use of angiotensin I converting enzyme inhibitors (ACEIs) and angiotensin II receptor antagonists (ARBs) as well as non-steroidal anti-inflammatory drugs (NSAIDS) and analgesic drugs. In a recent study, findings of the recent National Emergency X-Ray Utilization Study (NEXUS) also confirmed the use of ACEIs and ARBs as commonly used treatments in the acute care of MI patients and their use was associated with reduced rates of rehospitalization and adverse cardiac events. The use of NSAIDs was shown to improve short term mortality and reduce the need for rehospitalization.
What is myocardial infarction?
In MI, the heart muscle loses its ability to contract properly. This can result in a loss of feeling, muscle twitching, chest pain or shortness of breath. Complications can include lung infection and heart failure. MI requires immediate referral to a hospital if left untreated. Without medical attention, the risk of death decreases significantly each day that passes since the event. A typical adult MI can only be cured by open heart surgery (open heart), however, the rate of MI has more than doubled in the past 60 years. If untreated, there is more than 55 to 68% survival rate in hospitalized patients with uncomplicated MI compared to less than 39% in the overall population.
Can myocardial infarction be cured?
Incomplete MI can be cured by early interventions. Left ventricular function after an MI can be greatly improved but with considerable risk. The main goal for MI treatment should still be to reduce infarction size and heart failure.
What are the signs of myocardial infarction?
There is growing evidence that ischemia related symptoms can be predicted. Patients should be encouraged to report all ischemic symptoms. On careful examination chest pain should first be localized in the left lateral decubitus position and in those with a low risk, it may disappear over hours with bed rest. A high index of suspicion should be used for other symptoms like nausea, vomiting, sweating, palpitations, shortness of breath with exertion and dizziness, if they are not present there is a low index of suspicion in this population. Cardiac ischemia is a life-threatening medical emergency. Patients should be admitted to the cardiac ischemia unit if the patient was resuscitated and the electrocardiogram showed no ST elevation.
How many people get myocardial infarction a year in the United States?
About 1 in 6 Americans may suffer from what is a debilitating condition. In addition, some 1 in 12 people over the age of 45 die from a heart attack.
Does de-prescribe beta blocker therapy improve quality of life for those with myocardial infarction?
Results from a recent clinical trial shows that heart failure treatment for patients with myocardial infarction by way of de-prescribing of beta blockers is likely to result in improved QOL for patients with stable myocardial infarction.
How does de-prescribe beta blocker therapy work?
Beta blocker use was associated with a significantly lower risk of nonfatal myocardial infarction. Results from a recent paper support the use of beta blockers in patients with prior myocardial infarction.
Who should consider clinical trials for myocardial infarction?
Although clinical trials represent an important tool for assessing and resolving critical questions, the number of patients involved in the design of such trials is increasing. As a result, there is increasing pressure on clinical trial teams to recruit participants rapidly and effectively.
Is de-prescribe beta blocker therapy safe for people?
Beta blockers did not increase the incidence of HF-free days compared with nonbriefer patients. De-prescribing at an intensively managed specialist cardiac rehabilitation program for people with coronary heart disease could be implemented without a substantial increase in HF-free days.
Have there been any new discoveries for treating myocardial infarction?
Data from a recent study of the current trial are exciting. They are the first to demonstrate that, with appropriate medical management, exercise training can be used as an adjunct in patients with acute MI [to reduce heart failure morbidity and mortality rate by 40% in low-income African Americans over 50 years (3 years) of follow-up].
How serious can myocardial infarction be?
An increasing fraction of patients hospitalized in the U.S. during 2012 were hospitalized in the top 5% of readmissions. The average length of stay was 8.2 days, slightly below the average American stay. As readmissions from acute cardiac care doubled during 2012, the average cost to the system increased by over 90% between 1999 and 2012. As expected, age continues to be an important predictor of readmission: a 10% increase in age increased readmission rate to about 90% at a cost to the system approximately threefold greater. Furthermore, for the first time in the U.S. and the world, the fraction of readmissions is increasing among women and in whites.