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Acute myocardial infarction – Trials in Disease

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Ongoing Clinical Trials for Acute Myocardial Infarction

There are currently 21 clinical trials investigating new treatments and approaches for patients who have experienced a heart attack. These studies are evaluating medications to prevent blood clots, reduce cholesterol, protect heart muscle, manage blood pressure, and relieve pain. Trials are being conducted across Europe, including in countries such as Sweden, Denmark, Germany, Italy, France, Spain, Poland, Austria, and the Netherlands.

Clinical trial locations

Study Comparing Apixaban and Warfarin for Patients with Heart Clots After a Heart Attack

This clinical trial is investigating the best treatment for patients who develop blood clots in the heart’s left ventricle after experiencing a heart attack. The study compares two anticoagulant medications: apixaban and warfarin.

Who can participate: Adults aged 18 and older who have been diagnosed with left ventricular thrombosis following an acute heart attack are eligible. The blood clot must be confirmed through imaging tests such as an echocardiogram, MRI, or CT scan within 1 to 28 days after the heart attack. Women who are able to become pregnant must provide a negative pregnancy test and agree to use effective birth control throughout the study.

Who cannot participate: Patients with a history of left ventricular thrombosis or previous heart attacks are excluded from the study.

Focus of the trial: The study aims to determine which medication is more effective at dissolving heart blood clots over a three-month treatment period. Researchers will monitor participants using echocardiograms and possibly MRI or CT scans to assess how well the blood clot resolves. The trial also tracks bleeding events and major cardiovascular complications.

Medications being tested: Apixaban is given as an oral tablet at doses of 2.5 mg or 5 mg, while warfarin is administered as a 2.5 mg oral tablet. Both medications work by reducing blood clotting, but through different mechanisms. Apixaban blocks specific proteins involved in clot formation, whereas warfarin interferes with vitamin K, which is necessary for blood clotting.

Study Comparing Aspirin Alone to Aspirin and Fondaparinux in Patients with Non-ST-Elevation Myocardial Infarction (NSTEMI)

This clinical trial is focused on patients who have experienced a Non-ST-Elevation Myocardial Infarction, a type of heart attack that does not show the typical ST-segment elevation on an electrocardiogram. The study compares two treatment approaches: aspirin alone versus aspirin combined with fondaparinux.

Who can participate: Eligible participants must be older than 18 years and have a confirmed diagnosis of NSTEMI based on rising or falling cardiac troponin levels, symptoms of acute heart problems, or ECG changes. Participants must have an expected lifespan of more than one year and be able to provide written and oral informed consent.

Who cannot participate: Patients who have had a different type of heart attack than NSTEMI, those not within the specified age range, and individuals from vulnerable populations are excluded.

Focus of the trial: The study will evaluate which treatment approach is more effective in improving patient outcomes. Researchers will monitor participants for death, recurrent heart attacks, and the need for emergency coronary procedures within 30 days, as well as long-term outcomes up to 10 years. Secondary measures include the occurrence of stroke, length of hospital stay, and heart function at discharge.

Medications being tested: Aspirin is an oral medication that reduces pain and inflammation while making blood less sticky to prevent clots. Fondaparinux is given via subcutaneous injection and helps prevent blood clots by blocking a specific factor in the blood clotting process. The combination of these medications aims to provide better protection against heart-related complications.

Study on Bempedoic Acid with Atorvastatin and Ezetimibe for Patients with Coronary Artery Disease After Heart Attack

This clinical trial is investigating whether adding bempedoic acid to existing cholesterol-lowering therapy can help heart attack patients achieve their target cholesterol levels more effectively. The study is designed for patients who have experienced a heart attack and have not reached their cholesterol goals with standard treatment alone.

Who can participate: Eligible participants must be between 18 and 85 years old and have recently experienced a heart attack with successful intervention. They should be taking at least 40 mg of atorvastatin and 10 mg of ezetimibe daily but still have LDL cholesterol levels above 55 mg/dl after 6 weeks of treatment.

Who cannot participate: Patients who have had a previous heart attack, are outside the specified age range, are part of vulnerable populations, or have not been treated with the required combination of atorvastatin and ezetimibe are excluded.

Focus of the trial: The primary goal is to determine whether adding bempedoic acid to the existing dual therapy can help more patients achieve LDL cholesterol levels below 55 mg/dl within 8 weeks. The study will also monitor other health parameters including total cholesterol, HDL cholesterol, triglycerides, blood pressure, and quality of life.

Medications being tested: Atorvastatin lowers cholesterol by reducing liver cholesterol production. Ezetimibe reduces cholesterol absorption in the intestines. Bempedoic acid, given as a 180 mg daily tablet, inhibits an enzyme involved in cholesterol synthesis in the liver. Together, these medications aim to provide more comprehensive cholesterol control for patients who haven’t achieved their targets with standard therapy alone.

Study on Dabigatran and Phenprocoumon for Treating Left Ventricular Thrombosis After Heart Attack in Patients with STEMI

This clinical trial is studying two anticoagulant medications for treating blood clots in the heart’s left ventricle after a STEMI heart attack. The study compares dabigatran etexilate with phenprocoumon to determine their effectiveness in resolving blood clots.

Who can participate: Eligible participants must be 18 years or older, have been diagnosed with STEMI, undergone primary PCI, have a clinical risk score for left ventricular thrombus greater than 2 points, and have kidney function (eGFR) greater than 30 ml/min/1.73m². The blockage causing the heart attack must have occurred in the left anterior descending artery.

Who cannot participate: Patients with a history of allergic reactions to the study medications, severe kidney problems, active bleeding disorders, pregnancy or breastfeeding, recent major surgery, uncontrolled high blood pressure, or a history of stroke or heart attack in the last 6 months are excluded. Those currently participating in another clinical trial are also ineligible.

Focus of the trial: The study aims to estimate how many patients experience resolution of the blood clot and whether they develop new brain infarctions after three months of treatment. Researchers will use cardiac MRI and screening MRI to detect both visible and silent brain infarctions. The trial will also track bleeding events for up to one year.

Medications being tested: Dabigatran is given orally as hard capsules in 110 mg and 150 mg doses. It works by inhibiting thrombin, an enzyme involved in blood clot formation. Phenprocoumon is an oral anticoagulant that reduces the production of clotting factors in the liver by inhibiting vitamin K-dependent factors. Both medications aim to prevent blood clots, but they work through different mechanisms.

Study on Evolocumab for Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

This international clinical trial is evaluating whether evolocumab, a medication that significantly lowers LDL cholesterol, can help heart attack patients achieve healthier cholesterol levels more effectively than standard treatment strategies.

Who can participate: Eligible participants must have experienced either STEMI or NSTEMI and be taking a statin at the highest tolerable dose. For STEMI patients, certain age and timing criteria apply. For NSTEMI patients, additional risk factors are required, such as diabetes, peripheral arterial disease, multitruncular disease, previous heart attack or stroke, or reduced kidney function. Written informed consent is required.

Who cannot participate: Patients who have had a recent acute heart attack may not be eligible depending on specific study criteria.

Focus of the trial: The primary goal is to determine whether evolocumab can reduce LDL cholesterol by at least 50% from baseline and achieve levels below 1.4 mmol/L at 12 months. The study will follow participants for up to 36 months, with regular check-ups to monitor cholesterol levels and other health indicators. Researchers will also track how quickly participants reach target cholesterol levels and any changes in other blood lipids.

Medications being tested: Evolocumab is administered as a 140 mg subcutaneous injection using a pre-filled pen. It works by blocking a protein called PCSK9, which helps the liver remove LDL cholesterol from the bloodstream. This mechanism allows for significant reductions in bad cholesterol levels, potentially reducing the risk of future heart-related problems.

Study on Managing Heart Attack Risk with Icosapent Ethyl and Drug Combination for Patients at High Risk of Another Heart Attack

This multi-country clinical trial is investigating whether an intensified approach to managing cardiovascular risk factors can prevent future heart problems in patients who have recently experienced a heart attack. The study involves multiple medications taken orally.

Who can participate: Eligible participants must be over 18 years old and have undergone a percutaneous coronary intervention procedure for an acute heart attack within 48 hours to 14 days before joining the study. Participants must have specific health measurements available and provide written informed consent.

Who cannot participate: Patients who have had a recent heart attack, are not within the specified age range, or are part of vulnerable populations are excluded.

Focus of the trial: The study will monitor participants for major cardiovascular events including death, non-fatal heart attacks, non-fatal strokes, hospitalizations for urgent coronary procedures, and heart failure. Secondary outcomes include specific cardiovascular events and all-cause mortality. The trial aims to gather data on whether the intensified treatment approach can better prevent serious heart-related events compared to standard care.

Medications being tested: The trial involves several medications including Vazkepa (containing icosapent ethyl), colchicine, empagliflozin, atorvastatin, ramipril, aspirin, and metformin. These medications work through various mechanisms to manage cholesterol, blood pressure, blood sugar, and inflammation, providing comprehensive cardiovascular risk management.

Study on Selatogrel for Preventing Heart Attack in Patients with Recent Heart Attack History

This large-scale trial across multiple European countries is evaluating selatogrel, a medication that patients can self-administer at home when they experience symptoms suggesting another heart attack. The study aims to determine whether this early treatment approach can improve outcomes.

Who can participate: Eligible participants must be at least 18 years old, have experienced a confirmed Type 1 acute heart attack within the past 4 weeks, and have multivessel coronary artery disease with at least 50% narrowing in two or more coronary artery territories. Additional risk factors are required, such as a second prior heart attack, diabetes, chronic kidney disease, peripheral artery disease, or unsuccessful coronary revascularization. Participants must be able to successfully self-administer the treatment using an autoinjector.

Who cannot participate: Individuals who have had a recent heart attack but are not able to self-administer the medication, those not at risk of having another heart attack, individuals outside the specified age range, and those from vulnerable populations are excluded.

Focus of the trial: The study will monitor whether early self-administration of selatogrel can reduce death and recurrent heart attacks. Researchers will track major cardiovascular events and bleeding events within two days after treatment administration. Secondary outcomes include hospitalizations or emergency visits for heart failure within 30 days.

Medications being tested: Selatogrel is given as a subcutaneous injection that patients can administer themselves using a pre-filled injector. It works by blocking specific receptors involved in platelet activation, helping to prevent blood clots. The medication represents a novel approach to immediate treatment when heart attack symptoms occur.

Study on the Effects of Ramipril, Bisoprolol, and Dapagliflozin in Patients with ST-Elevation Myocardial Infarction (Heart Attack)

This Swedish clinical trial is investigating whether the timing of certain heart medications affects recovery after a STEMI heart attack. The study compares giving medications immediately versus later to determine the optimal treatment approach.

Who can participate: Eligible participants must have experienced a STEMI and undergone primary PCI within 6 hours of symptom onset. Informed consent is required, and both male and female patients of various age groups can participate.

Who cannot participate: Patients who have had a recent heart attack or myocardial ischemia, those not within the specified age range, and individuals from vulnerable populations are excluded.

Focus of the trial: The study evaluates how the timing of medication administration affects heart function and specific blood markers. Researchers will use echocardiography on day 7 to measure heart function, specifically global longitudinal strain. Blood tests will measure NT-proBNP levels, and cardiac MRI will assess the size of heart damage. The study also monitors cardiac troponin levels and other heart health indicators.

Medications being tested: Ramipril is an angiotensin converting enzyme inhibitor that helps relax blood vessels and lower blood pressure. Bisoprolol is a beta blocker that reduces heart workload and slows heart rate. Dapagliflozin is an SGLT2 inhibitor that helps lower blood sugar levels and has beneficial effects on heart health. All medications are taken orally.

Study on the Safety and Effectiveness of RTP-026 for Patients with ST-Elevation Myocardial Infarction (STEMI)

This Danish clinical trial is evaluating a new treatment called RTP-026 for patients experiencing STEMI heart attacks. The study focuses on both the safety and effectiveness of this experimental medication.

Who can participate: Eligible participants must be men between 18 and 80 years old or post-menopausal women up to 80 years old. They must have experienced sudden chest pain for less than 12 hours, have STEMI confirmed by ECG patterns, be eligible for primary PCI, and have a specific blood test result (NLR between 7 and 17) upon arrival or after the PCI procedure. Informed consent is required.

Who cannot participate: Patients who have had a recent STEMI, individuals not within the specified age range, and those part of vulnerable populations are excluded.

Focus of the trial: The study assesses the safety and effectiveness of RTP-026 compared to placebo. Researchers will monitor for adverse events such as severe low blood pressure, irregular heart rhythms, or heart failure during the first 72 hours after administration. The study includes cardiac MRI imaging at 48 hours and 90 days after treatment to measure heart damage and function. Blood tests will track specific markers related to inflammation and heart damage.

Medications being tested: RTP-026 is administered orally and is currently being studied for its potential to assist in treating STEMI. The medication is believed to work by modulating specific pathways involved in cardiac function, though the exact mechanism is still being researched. It is classified as a cardiovascular agent.

Study of early dapagliflozin treatment to reduce heart damage in patients with acute heart attack and reduced heart pumping function

This Italian clinical trial is investigating whether giving dapagliflozin early after a heart attack can help protect the heart and reduce the size of damaged heart muscle areas in patients with reduced heart pumping ability.

Who can participate: Eligible participants must be at least 18 years old, have STEMI with any affected heart artery, receive primary PCI within 12 hours from symptom onset, have severely reduced or no blood flow in the affected artery when receiving PCI, and show evidence of new abnormal heart wall movement with LVEF of 40% or less. Written informed consent is required.

Who cannot participate: Patients below 18 or above 65 years old, those with a previous heart attack, known allergy to SGLT-2 inhibitors, current participation in other trials, pregnancy or breastfeeding, severe kidney or liver problems, uncontrolled diabetes, recent stroke, life-threatening heart rhythm problems, recent major surgery, active bleeding or high bleeding risk, inability to provide consent, or history of substance abuse are excluded.

Focus of the trial: The study aims to determine whether early dapagliflozin treatment can provide heart protection and is safe for recent heart attack patients. Researchers will use cardiac MRI to measure the extent of heart damage and will monitor patients for heart-related complications over 3 months. The trial will also track changes in body weight, blood pressure, and various blood tests assessing heart and kidney function.

Medications being tested: Dapagliflozin is given as 10 mg film-coated tablets taken by mouth. It belongs to a class of medications called SGLT-2 inhibitors, which work by helping the kidneys remove excess sugar from the blood through urine. In this trial, the medication is being studied for its potential protective effects on the heart.

Study of Lower Blood Pressure Targets Using Noradrenaline in Patients with Heart Attack-Related Cardiogenic Shock

This multi-country European trial is studying whether using lower doses of noradrenaline to maintain lower blood pressure targets leads to better outcomes for patients with cardiogenic shock following a heart attack.

Who can participate: Eligible participants must have experienced either STEMI or NSTEMI, undergone early PCI within the last 7 days, and have cardiogenic shock with all of the following: low blood pressure below 90 mmHg for more than 30 minutes or requiring medications to maintain blood pressure, at least one sign of poor organ blood flow (mental status changes, cold skin, low urine output, or high blood lactate levels), and signs of fluid in the lungs. Both men and women 18 years or older can participate.

Who cannot participate: Patients below 18 or above 85 years old, pregnant or breastfeeding women, those with severe allergic reactions to similar medications, active uncontrolled bleeding, participation in another trial within 30 days, septic shock, terminal illness with life expectancy less than 30 days, severe brain injury or recent stroke, inability to provide consent without a legal representative, severe liver disease, end-stage kidney disease requiring dialysis, severe heart valve disease, recent major surgery, or do not resuscitate orders are excluded.

Focus of the trial: The study will monitor patients for 30 days after starting treatment, tracking survival, kidney function, and days spent outside the hospital. Researchers aim to determine if reduced noradrenaline dosing targeting lower blood pressure improves outcomes compared to standard treatment.

Medications being tested: Noradrenaline (norepinephrine) is administered intravenously to help increase blood pressure by tightening blood vessels. The trial is studying whether using less of this medication in patients with cardiogenic shock after a heart attack might lead to better outcomes.

Summary

The 21 ongoing clinical trials for acute myocardial infarction represent a diverse range of therapeutic approaches. Notable concentrations of research activity can be observed in several European countries, with Italy, Spain, and Germany hosting multiple trials.

Several trends emerge from these studies. Multiple trials focus on optimizing anticoagulation therapy, comparing newer agents like apixaban and dabigatran against traditional medications like warfarin. Cholesterol management is another major focus, with studies evaluating evolocumab and bempedoic acid in combination with statins. Several trials are investigating novel approaches to preventing recurrent cardiovascular events, including self-administered treatments like selatogrel.

The studies vary in duration from short-term safety assessments to long-term follow-up extending up to 10 years. Most trials include both men and women, with specific age ranges varying by study objectives. Common exclusion criteria include pregnancy, severe organ dysfunction, and recent participation in other clinical trials.

These trials collectively aim to improve outcomes for heart attack patients through better blood clot prevention, cholesterol control, heart muscle protection, and cardiovascular risk management. The geographic diversity of trial locations reflects the international collaboration in cardiovascular research, potentially improving access to innovative treatments across Europe.

Ongoing Clinical Trials on Acute myocardial infarction

  • Study on Managing Heart Attack Risk with Icosapent Ethyl and Drug Combination for Patients at High Risk of Another Heart Attack

    Recruiting

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    Austria Germany Poland

  • Study on the Safety of Ticagrelor and Aspirin in Patients with ST-Elevation Myocardial Infarction After Heart Procedure

    Recruiting

    1 1 1 1
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    The Netherlands

  • Study Comparing Apixaban and Warfarin for Patients with Heart Clots After a Heart Attack

    Recruiting

    1 1 1 1
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    Denmark Sweden

  • Study on Selatogrel for Preventing Heart Attack in Patients with Recent Heart Attack History

    Recruiting

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    Austria Belgium Bulgaria Croatia Czechia Denmark +17

  • Study of Lower Blood Pressure Targets Using Noradrenaline in Patients with Heart Attack-Related Cardiogenic Shock

    Recruiting

    1 1 1 1
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    Belgium Czechia Denmark Germany Greece The Netherlands +3

  • Study on Colchicine for Patients with Angina Symptoms and Coronary Microvascular Disease

    Recruiting

    1 1
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    Denmark

  • Study on Evolocumab for Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

    Recruiting

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    France Germany Italy Poland Spain

  • Bisoprolol in Patients After Myocardial Infarction with Preserved Ejection Fraction During Cardiac Rehabilitation

    Not yet recruiting

    1 1 1 1
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    Belgium

  • Sodium-glucose cotransporter-2 inhibitor drug combination for patients with diabetes and heart attack to slow coronary artery disease progression

    Not yet recruiting

    1 1 1 1
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    Italy

  • Methoxyflurane Compared to Morphine for Pain Relief in Patients with Acute Myocardial Infarction Before Hospital Admission

    Not yet recruiting

    1 1 1 1
    Investigated diseases:
    France

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