Long-term oral beta-blockade will be evaluated in approximately 5000 patients with acute MI and preserved EF to determine its effect on all-cause death or recurrent MI.
RCT (n=5,000)
Open-label
parallel
Yes
Does long-term oral beta-blockade reduce the composite endpoint of death of any cause or recurrent MI in patients with an acute MI and preserved left ventricular ejection fraction (EF ≥ 50%)?
The REDUCE-AMI trial is designed to evaluate the efficacy of long-term beta-blocker therapy in patients with acute MI and preserved ejection fraction in the modern era of reperfusion and biomarker-based diagnosis.
AIMS: Most trials showing benefit of beta-blocker treatment after myocardial infarction (MI) included patients with large MIs and are from an era before modern biomarker-based MI diagnosis and reperfusion treatment. The aim of the randomized evaluation of decreased usage of beta-blockers after acute myocardial infarction (REDUCE-AMI) trial is to determine whether long-term oral beta-blockade in patients with an acute MI and preserved left ventricular ejection fraction (EF) reduces the composite endpoint of death of any cause or recurrent MI. METHODS AND RESULTS: It is a registry-based, randomized, parallel, open-label, multicentre trial performed at 38 centres in Sweden, 1 centre in Estonia, and 6 centres in New Zealand. About 5000 patients with an acute MI who have undergone coronary angiography and with EF ≥ 50% will be randomized to long-term treatment with beta-blockade or not. The primary endpoint is the composite endpoint of death of any cause or new non-fatal MI. There are several secondary endpoints, including all-cause death, cardiovascular death, new MI, readmission because of heart failure and atrial fibrillation, symptoms, functional status, and health-related quality of life after 6-10 weeks and after 1 year of treatment. Safety endpoints are bradycardia, AV-block II-III, hypotension, syncope or need for pacemaker, asthma or chronic obstructive pulmonary disease, and stroke. CONCLUSION: The results from REDUCE-AMI will add important evidence regarding the effect of beta-blockers in patients with MI and preserved EF and may change guidelines and clinical practice.
Yndigegn et al. (Mon,) conducted a rct in Acute myocardial infarction with preserved ejection fraction (n=5,000). Oral beta-blockade vs. No beta-blockade was evaluated on Composite of death of any cause or new non-fatal MI. Long-term oral beta-blockade will be evaluated in approximately 5000 patients with acute MI and preserved EF to determine its effect on all-cause death or recurrent MI.