Metoprolol to Reduce Perioperative Myocardial Injury

• Status: Active, not recruiting
• Trial end date: 2022-12-31
• Target enrollment: 0
• Participant gender: All

Summary

The purpose of this research study is to test if a commonly used, FDA-approved medication, called metoprolol, given during and after surgery, reduces the possibility of heart related complications in patients with CAD.

• Phase: Phase 3
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Washington University School of Medicine
• Collaborator: National Heart, Lung, and Blood Institute (NHLBI)
• Treatments: Metoprolol

Criteria

Inclusion Criteria

1. Age >= 50 years

2. Beta-blocker naïve [30 days prior to surgery]

3. Previously diagnosed CAD, or

1. History of PVD, or

2. CKD [eGFR ≤60ml/min], or

3. History of positive stress test or

4. At high risk for CAD (must meet at least 2 criteria):

i. Age >= 70 years ii. Hypertension iii. Diabetes requiring oral medication or insulin iv. Current smoker or some days smoker within the past 2 years

4. Major non-cardiac, elective surgery under general anesthesia

Exclusion Criteria

Subjects will not be enrolled if any of the following criteria exist:

1. History of stroke, or TIA

2. Previously diagnosed carotid disease, i.e., either 70% unilateral or 50% bilateral carotid occlusion.

3. Heart rate <=55bpm

4. Congestive heart failure with New York Heart Association(NYHA) Functional Classification of III-IV or left ventricular heart failure with ejection fraction ≤50%

5. Severe valvular regurgitation

6. Second or third degree AV block without pacemaker

7. Active asthma or COPD with symptoms or resolving symptoms on day of surgery

8. Anemia [HB<=9g/dL]

9. Allergy to beta-blockade drugs

10. Unwilling or unable to give consent for participation

11. Undergoing any carotid endarterectomy, endovascular, endoscopic, superficial, or ambulatory procedures

12. Pregnancy or lactating women

13. Prisoners