NCT06736353

Effect of Classic Secondary Prevention in Type 2 MI: A Target Trial Emulation Study

Completed Last updated 19 March 2025

What this trial tests

trial testing Beta Blocker Therapy or No Therapy (Control) in Myocardial Infarction Type 2 in 14,000 participants. Completed in 5 May 2022.

Timeline

3 September 2010

Primary endpoint
5 May 2022

5 May 2022

Quick facts

Lead sponsor	Uppsala University
Status	Completed
Study type	OBSERVATIONAL
Enrollment	14,000
Start date	3 September 2010
Primary completion	5 May 2022
Estimated completion	5 May 2022
Sites	1 location across Sweden

Drugs / interventions tested

• Beta Blocker Therapy or No Therapy (Control) — full drug profile →
• RAAS blocker Therapy or No therapy (Control) — full drug profile →
• Statin Therapy or No Therapy (Control) — full drug profile →
• Single Antiplatelet Therapy or No Therapy (Control) — full drug profile →
• Dual Antiplatelet Therapy or No Therapy (Control) — full drug profile →

Conditions studied

• Myocardial Infarction Type 2 — all drugs for Myocardial Infarction Type 2 →

Sponsor

Uppsala University

Who can join

18 and older, any sex, with Myocardial Infarction Type 2. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

A classic heart attack is caused by a blockage to the coronary arteries that supplies the heart muscle with oxygenated blood. The medical term for this condition is type 1 myocardial infarction. There is strong scientific evidence that the usage of pharmacological drugs such as statins, beta blockers, Renin-Angiotensin-Aldosterone System blockers and platelet inhibitors after a type 1 myocardial infarction improves survival and reduces the risk for new myocardial infarctions. However, a myocardial infarction may also occur without blockage to the coronary arteries when other acute conditions causes either a decreased supply or an increased demand of oxygenated blood to the heart. The medical term for the latter is type 2 myocardial infarction. There are currently no scientific evidence that any pharmacological drug improves survival in patients with a type 2 myocardial infarction, of whom only one in three patients are alive after five years.

The aim of this study is to investigate if those drugs that improves the prognosis after a type 1 myocardial infarction (Beta blockers, Renin-Angiotensin-Aldosterone System blockers, Statins and platelet inhibitors) also affects the prognosis after a type 2 myocardial infarction.

The best way to answer this question would be to conduct clinical trials for each drug where type 2 myocardial infarction patients are randomized to either receiving the drug of interest or receiving placebo (sugar pills) and then compare the survival and outcomes in both groups over time.

However, clinical trials are costly, time consuming and also difficult to conduct with type 2 myocardial infarction patients since these patients are treated at various hospital departments.

Therefore, this study will instead include patients in a Swedish national register for myocardial infarction, in which myocardial infarction patients are reported from all Swedish hospitals, and compare type 2 myocardial infarction patients that did receive or did not receive each treatment. To minimize the risk of making inaccurate conclusions about the causal relationship between treatment and outcome, the study will define the optimal clinical trial for each treatment and then specifically emulate these trials in all possible aspects using the register data. This method is called "target trial emulation".

Publications & conference data

No peer-reviewed publications indexed yet for this trial. Completed trials usually publish results within 12-18 months.