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Myocardial InfarctionOBTAINNCT00430612

The PACE-MI Registry Study - Outcomes of Beta-blocker Therapy After Myocardial Infarction (OBTAIN)

An observational study of Myocardial Infarction, run by Northwestern University at 23 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of the PACE-MI (OBTAIN) registry is: Analyze beta-blocker dose response effect on outcome over two years Explore gender and minority differences in beta-blocker utilization and outcomes. Read more about this study

Who is it for?
Ages 30 years and older
Conditions the study is for
Myocardial Infarction
How many people
7,057 participants
Where
23 sitesin 2 countries
Study dates
May 2009to Oct 2015
How long will I take part?
2 Years
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 30 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: non-voluntary registry of consecutive patients diagnosed as having a MI at each study site

Who may be able to join

  • 1. Consecutive patients admitted with a myocardial infarction documented by both of the following:
  • cardiac enzymes (CPK elevation > two times or troponin elevation > three times the upper limit of normal for the lab)
  • Electrocardiographic changes and/or symptoms consistent with myocardial infarction (i.e. chest pain, shortness of breath)
  • No Exclusion Criteria

Who cannot join

None listed.

Trial locations and contacts

23 sites in 2 countries.

23 sites in 2 countries

United States22 sites
  • Amarillo Heart Clinic Research Institute, Inc.

    Amarillo, Texas, 79106

  • Austin Heart PLLC

    Austin, Texas, 78756

  • Winthrop University Hospital

    Bethpage, New York, 11714

  • Bridgeport Hospital

    Bridgeport, Connecticut, 06610

  • Maimonides Medical Center

    Brooklyn, New York, 11219

  • Fletcher Allen Health Care

    Burlington, Vermont, 05401

  • Northwestern Memorial Hospital

    Chicago, Illinois, 60611

  • OhioHealth Research Institute

    Columbus, Ohio, 43214

  • Henry Ford Hospital

    Detroit, Michigan, 48202

  • Clarian Health/Methodist Research Institute

    Indianapolis, Indiana, 46202

  • Little Rock Cardiology Clinic

    Little Rock, Arkansas, 72211

  • MemorialCare Heart and Vascular Institute - Long Beach Memorial Medical Center

    Long Beach, California, 90806

  • West Los Angeles VA Medical Center

    Los Angeles, California, 90073

  • Baptist Memorial Hospital

    Memphis, Tennessee, 38120

  • Baptist Cardiac and Vascular Institute

    Miami, Florida, 33176

  • University of Oklahoma Health Sciences Center

    Oklahoma City, Oklahoma, 73104

  • Orlando Regional Medical Center

    Orlando, Florida, 32806

  • University of Pittsburgh Medical Center

    Pittsburgh, Pennsylvania, 15213

  • Rhode Island Hospital

    Providence, Rhode Island, 02903

  • Strong Memorial Hospital (University of Rochester School of Medicine)

    Rochester, New York, 14642

  • Park Nicollet

    Saint Louis Park, Minnesota, 55426

  • Providence Health Center

    Waco, Texas, 76712

Other trials in United States

Canada1 site
  • University of Calgary

    Calgary, Alberta, T2N 4N1

Other trials in Canada

About this study

The purpose of the PACE-MI (OBTAIN) registry is:

  • Analyze beta-blocker dose response effect on outcome over two years
  • Explore gender and minority differences in beta-blocker utilization and outcomes.

In patients with Myocardial Infarction (MI) discharged from the hospital, beta-blocker dose will be predictive of survival.

Exploratory analyses: Gender and racial effects-gender and race are, similarly, hypothesized to be predictive of post-MI survival.

The existence of interactions between gender and beta-blocker effect as well as race and beta-blocker effect will also be evaluated.

Read the detailed description

Methods

All patients admitted to the coronary care areas with an acute myocardial infarction will be entered into the registry. At the time of discharge from the coronary care unit, clinical data will be entered. The registry will include approximately 6800 patients.

As there is no intervention in the registry, the data to be collected are standard for quality assurance purposes and cannot practicably be carried out without waivers of consent and HIPAA authorization, there will be no consent specifically for registry patients at baseline. Systems have been implemented to ensure the registry data will remain confidential. Sites have received IRB approval of waiver of consent and HIPAA for the baseline registry data.

Data to be collected will include demographic (including ethnic and race classifications according to NIH guidelines) data and information regarding the index myocardial infarction. Use of beta-blockers at discharge from the coronary care unit will be documented. In addition, beta-blocker use at hospital discharge will be noted. Data for the registry will be obtained from ER notes, admission notes, cardiac catheterization lab reports, medication lists, lab reports, and discharge summaries.

Follow-Up

Follow-up for registry patients will be conducted at year 1 and year 2 post-myocardial infarction. Data may be obtained via medical chart review, phone contact, and Social Security Death Index (SSDI). For follow-up information obtained via chart review or the SSDI, a detailed justification for waiver of HIPAA and consent requirements is attached to this protocol. If phone contact is required with the patient, we are suggesting the following process:

  • A letter should be sent out to the patient approximately one week prior to the contact in which the rationale for the study will be provided, as well as a delineation of the patient's right to participate or not to participate (by either providing or not providing the requested information).
  • At telephone contact with the patient, the coordinator will document whether the patient consents to provide the information. If the patient consents, the coordinator will proceed to obtain the requested information.
  • In the event that the participating institution's IRB requires a written, signed consent for this verbal contact, a written consent form template is provided.

Data collected at follow-up interview will include vital status, beta-blocker use, other cardiac medications and any cardiovascular hospitalizations.

Keywords
Myocardial Infarction, Heart Attack, Beta Blockers, Survival
Medical subject headings
Myocardial Infarction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT00430612
Study groupRoleWhat they receive
All Registry ParticipantsNon-voluntary registry of consecutive patients diagnosed as having a MI at each study site.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Total mortality at 2 years post myocardial infarction

    Compare Kaplan Meier survival curves for the following 5 beta-blocker dose groups:

    No beta-blockers - 12.5% (>0 - 12.5%) 25% (>12.5 - 25%) - 50% (>25 - 50%) Full Dose (>50%)

    Measured: Measured at Years 1 and 2

Secondary outcomes (1)
  1. Total mortality - secondary analysis

    Compare Kaplan-Meier survival curves for the following 2 beta-blocker dose groups:

    Very Low Dose (>0-25%) vs. High Dose (≥50%)

    Measured: Measured at Year 1 and Year 2

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Feb 2007 (estimated)
  2. Study startMay 2009
  3. Primary completionDec 2013
  4. Study completionOct 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Other
Time perspective
Prospective
Enrolment
7,057 participants (actual)
Target duration
2 Years
IDs, dates and publications
ClinicalTrials.gov ID
NCT00430612
Sponsor's protocol ID
469
Other IDs
U01HL080416
Acronym
OBTAIN
Status last verified
Apr 2023
First submitted
31 Jan 2007
Last updated
24 Apr 2023
Results posted
No
Data monitoring committee
Yes

Publications

  • Wikstrand J, Hjalmarson A, Waagstein F, Fagerberg B, Goldstein S, Kjekshus J, Wedel H; MERIT-HF Study Group. Dose of metoprolol CR/XL and clinical outcomes in patients with heart failure: analysis of the experience in metoprolol CR/XL randomized intervention trial in chronic heart failure (MERIT-HF). J Am Coll Cardiol. 2002 Aug 7;40(3):491-8. doi: 10.1016/s0735-1097(02)01970-8.

    PubMed 12142116
  • Metra M, Torp-Pedersen C, Swedberg K, Cleland JG, Di Lenarda A, Komajda M, Remme WJ, Lutiger B, Scherhag A, Lukas MA, Charlesworth A, Poole-Wilson PA. Influence of heart rate, blood pressure, and beta-blocker dose on outcome and the differences in outcome between carvedilol and metoprolol tartrate in patients with chronic heart failure: results from the COMET trial. Eur Heart J. 2005 Nov;26(21):2259-68. doi: 10.1093/eurheartj/ehi386. Epub 2005 Jul 21.

    PubMed 16040619
  • Dobre D, van Veldhuisen DJ, Mordenti G, Vintila M, Haaijer-Ruskamp FM, Coats AJ, Poole-Wilson PA, Flather MD; SENIORS Investigators. Tolerability and dose-related effects of nebivolol in elderly patients with heart failure: data from the Study of the Effects of Nebivolol Intervention on Outcomes and Rehospitalisation in Seniors with Heart Failure (SENIORS) trial. Am Heart J. 2007 Jul;154(1):109-15. doi: 10.1016/j.ahj.2007.03.025.

    PubMed 17584562
  • Cucherat M. Quantitative relationship between resting heart rate reduction and magnitude of clinical benefits in post-myocardial infarction: a meta-regression of randomized clinical trials. Eur Heart J. 2007 Dec;28(24):3012-9. doi: 10.1093/eurheartj/ehm489. Epub 2007 Nov 2.

    PubMed 17981830
  • Kjekshus JK. Importance of heart rate in determining beta-blocker efficacy in acute and long-term acute myocardial infarction intervention trials. Am J Cardiol. 1986 Apr 25;57(12):43F-49F. doi: 10.1016/0002-9149(86)90888-x.

    PubMed 2871745
  • Chen ZM, Pan HC, Chen YP, Peto R, Collins R, Jiang LX, Xie JX, Liu LS; COMMIT (ClOpidogrel and Metoprolol in Myocardial Infarction Trial) collaborative group. Early intravenous then oral metoprolol in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet. 2005 Nov 5;366(9497):1622-32. doi: 10.1016/S0140-6736(05)67661-1.

    PubMed 16271643
  • POISE Study Group; Devereaux PJ, Yang H, Yusuf S, Guyatt G, Leslie K, Villar JC, Xavier D, Chrolavicius S, Greenspan L, Pogue J, Pais P, Liu L, Xu S, Malaga G, Avezum A, Chan M, Montori VM, Jacka M, Choi P. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet. 2008 May 31;371(9627):1839-47. doi: 10.1016/S0140-6736(08)60601-7. Epub 2008 May 12.

    PubMed 18479744
  • Gottlieb S, Harpaz D, Shotan A, Boyko V, Leor J, Cohen M, Mandelzweig L, Mazouz B, Stern S, Behar S. Sex differences in management and outcome after acute myocardial infarction in the 1990s: A prospective observational community-based study. Israeli Thrombolytic Survey Group. Circulation. 2000 Nov 14;102(20):2484-90. doi: 10.1161/01.cir.102.20.2484.

    PubMed 11076821
  • Wilkinson P, Laji K, Ranjadayalan K, Parsons L, Timmis AD. Acute myocardial infarction in women: survival analysis in first six months. BMJ. 1994 Sep 3;309(6954):566-9. doi: 10.1136/bmj.309.6954.566.

    PubMed 7916229
  • Mahon NG, McKenna CJ, Codd MB, O'Rorke C, McCann HA, Sugrue DD. Gender differences in the management and outcome of acute myocardial infarction in unselected patients in the thrombolytic era. Am J Cardiol. 2000 Apr 15;85(8):921-6. doi: 10.1016/s0002-9149(99)00902-9.

    PubMed 10760327
  • Vaccarino V, Krumholz HM, Yarzebski J, Gore JM, Goldberg RJ. Sex differences in 2-year mortality after hospital discharge for myocardial infarction. Ann Intern Med. 2001 Feb 6;134(3):173-81. doi: 10.7326/0003-4819-134-3-200102060-00007.

    PubMed 11177329
  • A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results. JAMA. 1982 Mar 26;247(12):1707-14. doi: 10.1001/jama.1982.03320370021023.

    PubMed 7038157
  • Olsson G, Wikstrand J, Warnold I, Manger Cats V, McBoyle D, Herlitz J, Hjalmarson A, Sonneblick EH. Metoprolol-induced reduction in postinfarction mortality: pooled results from five double-blind randomized trials. Eur Heart J. 1992 Jan;13(1):28-32. doi: 10.1093/oxfordjournals.eurheartj.a060043.

    PubMed 1533587
  • Rochon PA, Anderson GM, Tu JV, Clark JP, Gurwitz JH, Szalai JP, Lau P. Use of beta-blocker therapy in older patients after acute myocardial infarction in Ontario. CMAJ. 1999 Nov 30;161(11):1403-8.

    PubMed 10906894
  • Soumerai SB, McLaughlin TJ, Spiegelman D, Hertzmark E, Thibault G, Goldman L. Adverse outcomes of underuse of beta-blockers in elderly survivors of acute myocardial infarction. JAMA. 1997 Jan 8;277(2):115-21.

    PubMed 8990335

Questions about this trial

What is this clinical trial studying?

An observational study of Myocardial Infarction, run by Northwestern University at 23 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Apr 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 23 sites in United States, Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Total mortality at 2 years post myocardial infarction (time frame: Measured at Years 1 and 2). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00430612, which also lists 28 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Apr 2023.

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