Early intravenous landiolol to limit heart muscle damage after STEMI
The Impact of Sympathetic Drive Control With Cardio-Selective Beta-Blockers on Infarct Size After Acute Myocardial Infarction
This study tries early IV landiolol versus standard oral beta-blockers to see if it reduces the amount of heart muscle damage in adults with STEMI who undergo primary PCI.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 100 (estimated) |
| Ages | 18 Years to 80 Years |
| Sex | All |
| Sponsor | Aristotle University Of Thessaloniki Academic / other |
| Locations | 1 site (Thessaloniki, Thessaloniki) |
| Trial ID | NCT07293832 on ClinicalTrials.gov |
What this trial studies
This is a prospective observational cohort enrolling adults with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention who receive either early intravenous landiolol or standard oral β-blocker therapy. Treatment choice is made by the attending cardiologist per current ESC guidance rather than by random assignment. Final infarct size will be measured by cardiac magnetic resonance imaging, and comparisons will adjust for baseline clinical differences. Because the design is nonrandomized, results will show associations and may be confounded by treatment selection.
Who should consider this trial
Good fit: Adults 18–80 years old with ST-elevation ≥2 mm in contiguous leads presenting within 12 hours and scheduled for primary PCI who are not on chronic beta-blockers and can give informed consent.
Not a fit: Patients with prior myocardial infarction, chronic beta-blocker use, hemodynamic instability (low blood pressure, bradycardia, high Killip class), advanced AV block, or bronchospasm are unlikely to be eligible or to benefit from this approach in this protocol.
Why it matters
Potential benefit: If successful, early IV landiolol could reduce infarct size after STEMI and help preserve heart function.
How similar studies have performed: Early IV beta-blocker approaches (for example, IV metoprolol in METOCARD-CNIC) have shown reduced infarct size in some studies but results across trials are mixed and landiolol itself is less well studied.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age between 18 and 80 years * Patients with electrocardiogram showing ST-segment elevation ≥2 mm in 2 or more contiguous leads for more than 30 minutes * Estimated time from symptom onset to reperfusion ≤12 hours * Patients scheduled to undergo primary angioplasty * Patients who have signed a consent form Exclusion Criteria: * Patients receiving chronic medication with beta-adrenergic blockers * Patients with a previous myocardial infarction * Persistent systolic blood pressure \<90 mmHg * Persistent heart rate \<55 beats per minute * Patients with Killip class III (acute pulmonary edema) or IV (cardiogenic shock) on initial examination * 12-lead electrocardiogram with PR interval \>200 milliseconds * 12-lead electrocardiogram showing second- or third-degree atrioventricular block * Bronchospasm requiring bronchodilator treatment * Possible pregnancy or postpartum period * Inability or refusal to sign the consent form
Where this trial is running
Thessaloniki, Thessaloniki
- Hippokration General Hospital of Thessaloniki — Thessaloniki, Thessaloniki, Greece (Recruiting)
Study contacts
- Principal investigator: Nikolaos Fragakis, Professor fo Cardiology, PhD — Aristotle University Of Thessaloniki
- Study coordinator: Athina Nasoufidou, MD, MSc, PhDc
- Email: athinanassi@gmail.com
- Phone: (+30) 2313236344
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.