Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Feb 2;9(2):192-197.
doi: 10.1093/ehjcvp/pvac070.

Design and rationale of randomized evaluation of decreased usage of beta-blockers after acute myocardial infarction (REDUCE-AMI)

Troels Yndigegn  1 , Bertil Lindahl  2 , Joakim Alfredsson  3 , Jocelyne Benatar  4 , Lisa Brandin  5 , David Erlinge  1 , Urban Haaga  6 , Claes Held  2 , Pelle Johansson  7 , Patric Karlström  8 , Thomas Kellerth  6 , Toomas Marandi  9 , Katarina Mars  10 , Annica Ravn-Fischer  11 , Johan Sundström  2   12 , Ollie Östlund  2 , Robin Hofmann  10 , Tomas Jernberg  13
Affiliations
Randomized Controlled Trial

Design and rationale of randomized evaluation of decreased usage of beta-blockers after acute myocardial infarction (REDUCE-AMI)

Troels Yndigegn et al. Eur Heart J Cardiovasc Pharmacother. .

Abstract

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.

Keywords: Beta-blocker; Clinical trial; Myocardial infarction; Outcome; RRCT; Registry.

PubMed Disclaimer

Figures

Graphical Abstract
Graphical Abstract
Central illustration.
Figure 1
Figure 1
Screening, randomization and follow-up.
See this image and copyright information in PMC

References

    1. The Norwegian Multicenter Study Group . Timolol-induced reduction in mortality and reinfarction in patients surviving acute myocardial infarction. N Engl J Med 1981;304:801–807. - PubMed
    1. Hjalmarson A, Elmfeldt D, Herlitz J, Holmberg S, Málek I, Nyberg G, Rydén L, Swedberg K, Vedin A, Waagstein F, Waldenström A, Waldenström J, Wedel H, Wilhelmsen L, Wilhelmsson C. Effect on mortality of metoprolol in acute myocardial infarction. A double-blind randomised trial. Lancet 1981;2:823–827. - PubMed
    1. A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results. JAMA 1982;247:1707–1714. - PubMed
    1. Bangalore S, Makani H, Radford M, Thakur K, Toklu B, Katz SD, DiNicolantonio JJ, Devereaux PJ, Alexander KP, Wetterslev J, Messerli FH. Clinical outcomes with beta-blockers for myocardial infarction: a meta-analysis of randomized trials. Am J Med 2014;127:939–953. - PubMed
    1. Dondo TB, Hall M, West RM, Jernberg T, Lindahl B, Bueno H, Danchin N, Deanfield JE, Hemingway H, Fox KAA, Timmis AD, Gale CP. beta-Blockers and mortality after acute myocardial infarction in patients without heart failure or ventricular dysfunction. J Am Coll Cardiol 2017;69:2710–2720. - PMC - PubMed

Publication types