Acute myocardial infarction myocardial infarction
Conditions
Interventions
In the early up-titration group, patients receive MRA, SGLT2 inhibitor, ARNI, and beta-blocker within 1 month, followed by dose up-titration of anti-heart failure medications. In the usual care group,
Sponsors
Saito Yuichi
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1) Patients with acute myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI) within 48 hours 2) Left ventricular ejection fraction (LVEF) less than 50% and/or NT-proBNP more than 400 pg/mL 3) Informed consent by the patient or representative within 7 days after PCI 4) Patients who can tolerate MRA<, SGLT2 inhibitor, ARNI, and bata-blocker
Exclusion criteria
Exclusion criteria: 1) Patients with PCI failure 2) Patients who are estimated to die during hospitalization 3) Patients with projected mortality within 1 year 4) Patients who cannot be followed up at an outpatient department 5) Patients treated with MRA, SGLT2 inhibitor, ARNI, and beta-blocker before acute MI 6) Patients with renal dysfunction (estimated glomerular filtration rate less than 30 ml/min/1.73 m2) 7) Patients with hypotension (systolic blood pressure less than 100 mmHg) 8) Patients who are deemed to be unsuitable for this study by the investigators
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Relative change in NT-proBNP at 1 year | — |
Secondary
| Measure | Time frame |
|---|---|
| Cardiovascular death, MI, stroke, heart failure hospitalization, and new-onset atrial fibrillation Drug discontinuation due to hypotension and hyperkalemia Renal function (eGFR at 1 year) | — |
Contacts
Public ContactYuichi Saito
Chiba University Hospital
Outcome results
None listed