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Randomized evaluation of beta blocker and ACE-inhibitor/angiotensin receptor blocker treatment in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA-BAT) : Rationale and design: MINOCA-BAT: Rationale and design

Nordenskjöld, Anna M. ; Agewall, Stefan ; Atar, Dan ; Baron, Tomasz ; Beltrame, John ; Bergström, Olle ; Erlinge, David LU orcid ; Gale, Chris P. ; López-Pais, Javier and Jernberg, Tomas , et al. (2021) In American Heart Journal 231. p.96-104
Abstract

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is common and occurs in 6–8% of all patients fulfilling the diagnostic criteria for acute myocardial infarction (AMI). This paper describes the rationale behind the trial ‘Randomized Evaluation of Beta Blocker and ACE-Inhibitor/Angiotensin Receptor Blocker Treatment (ACEI/ARB) of MINOCA patients’ (MINOCA-BAT) and the need to improve the secondary preventive treatment of MINOCA patients. Methods: MINOCA-BAT is a registry-based, randomized, parallel, open-label, multicenter trial with 2:2 factorial design. The primary aim is to determine whether oral beta blockade compared with no oral beta blockade, and ACEI/ARB compared with no ACEI/ARB, reduce the composite endpoint... (More)

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is common and occurs in 6–8% of all patients fulfilling the diagnostic criteria for acute myocardial infarction (AMI). This paper describes the rationale behind the trial ‘Randomized Evaluation of Beta Blocker and ACE-Inhibitor/Angiotensin Receptor Blocker Treatment (ACEI/ARB) of MINOCA patients’ (MINOCA-BAT) and the need to improve the secondary preventive treatment of MINOCA patients. Methods: MINOCA-BAT is a registry-based, randomized, parallel, open-label, multicenter trial with 2:2 factorial design. The primary aim is to determine whether oral beta blockade compared with no oral beta blockade, and ACEI/ARB compared with no ACEI/ARB, reduce the composite endpoint of death of any cause, readmission because of AMI, ischemic stroke or heart failure in patients discharged after MINOCA without clinical signs of heart failure and with left ventricular ejection fraction ≥40%. A total of 3500 patients will be randomized into four groups; e.g. ACEI/ARB and beta blocker, beta blocker only, ACEI/ARB only and neither ACEI/ARB nor beta blocker, and followed for a mean of 4 years. While patients with MINOCA have an increased risk of serious cardiovascular events and death, whether conventional secondary preventive therapies are beneficial has not been assessed in randomized trials. There is a limited basis for guideline recommendations in MINOCA. Furthermore, studies of routine clinical practice suggest that use of secondary prevention therapies in MINOCA varies considerably. Thus results from this trial may influence future treatment strategies and guidelines specific to MINOCA patients.

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type
Contribution to journal
publication status
published
subject
in
American Heart Journal
volume
231
pages
9 pages
publisher
Mosby-Elsevier
external identifiers
  • pmid:33203618
  • scopus:85096009117
ISSN
0002-8703
DOI
10.1016/j.ahj.2020.10.059
language
English
LU publication?
yes
id
45f5e2a7-6abe-48dd-9480-6b53911d10e9
date added to LUP
2020-12-08 15:19:15
date last changed
2024-06-13 01:21:01
@article{45f5e2a7-6abe-48dd-9480-6b53911d10e9,
  abstract     = {{<p>Myocardial infarction with non-obstructive coronary arteries (MINOCA) is common and occurs in 6–8% of all patients fulfilling the diagnostic criteria for acute myocardial infarction (AMI). This paper describes the rationale behind the trial ‘Randomized Evaluation of Beta Blocker and ACE-Inhibitor/Angiotensin Receptor Blocker Treatment (ACEI/ARB) of MINOCA patients’ (MINOCA-BAT) and the need to improve the secondary preventive treatment of MINOCA patients. Methods: MINOCA-BAT is a registry-based, randomized, parallel, open-label, multicenter trial with 2:2 factorial design. The primary aim is to determine whether oral beta blockade compared with no oral beta blockade, and ACEI/ARB compared with no ACEI/ARB, reduce the composite endpoint of death of any cause, readmission because of AMI, ischemic stroke or heart failure in patients discharged after MINOCA without clinical signs of heart failure and with left ventricular ejection fraction ≥40%. A total of 3500 patients will be randomized into four groups; e.g. ACEI/ARB and beta blocker, beta blocker only, ACEI/ARB only and neither ACEI/ARB nor beta blocker, and followed for a mean of 4 years. While patients with MINOCA have an increased risk of serious cardiovascular events and death, whether conventional secondary preventive therapies are beneficial has not been assessed in randomized trials. There is a limited basis for guideline recommendations in MINOCA. Furthermore, studies of routine clinical practice suggest that use of secondary prevention therapies in MINOCA varies considerably. Thus results from this trial may influence future treatment strategies and guidelines specific to MINOCA patients.</p>}},
  author       = {{Nordenskjöld, Anna M. and Agewall, Stefan and Atar, Dan and Baron, Tomasz and Beltrame, John and Bergström, Olle and Erlinge, David and Gale, Chris P. and López-Pais, Javier and Jernberg, Tomas and Johansson, Pelle and Ravn-Fisher, Annica and Reynolds, Harmony R. and Somaratne, Jithendra B. and Tornvall, Per and Lindahl, Bertil}},
  issn         = {{0002-8703}},
  language     = {{eng}},
  pages        = {{96--104}},
  publisher    = {{Mosby-Elsevier}},
  series       = {{American Heart Journal}},
  title        = {{Randomized evaluation of beta blocker and ACE-inhibitor/angiotensin receptor blocker treatment in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA-BAT) : Rationale and design: MINOCA-BAT: Rationale and design}},
  url          = {{http://dx.doi.org/10.1016/j.ahj.2020.10.059}},
  doi          = {{10.1016/j.ahj.2020.10.059}},
  volume       = {{231}},
  year         = {{2021}},
}