Study on Early Versus Late Use of Beta Blockers, ACE Inhibitors, and SGLT2 Inhibitors After Heart Attack STEMI

What this Trial Is About

This research aims to study patients with ST-elevation myocardial infarction STEMI who have undergone primary percutaneous coronary intervention PCI within 6 hours of symptom onset. The trial investigates how starting beta blockers, angiotensin converting enzyme inhibitors ACEI, and sodiumglucose cotransporter 2 SGLT2 inhibitors immediately versus delaying their start affects early heart remodeling and important heart function markers. Participants are randomly assigned to receive either bisoprolol, ramipril, and dapagliflozin within 24 hours of PCI or to delay these medications until about a week after PCI. This open-label trial uses a 2x2x2 factorial design to compare early versus late administration of these three drugs. Treatment timing is closely monitored to assess their individual and combined effects on heart recovery after STEMI. During the study, participants will have echocardiographic scans to measure heart function, including global longitudinal strain and left ventricular ejection fraction, mainly at day 7 after PCI. Blood tests will measure heart-related biomarkers such as NT-proBNP and cardiac troponins at day 7 and day 30. Researchers track these results to understand how early or late treatment influences heart healing. The trial will continue until the end of 2027 and includes safety monitoring and follow-up assessments.

STunning in Acute Myocardial Infarction - BAS