They say the early bird gets the worm. And that’s no exception in the case of a heart attack.
A recent study found that heart attack patients who received the inexpensive beta-blocker (blood-pressure reducer) metoprolol, en route to the hospital reduced damage to the heart significantly during a heart attack.
The study, done in Spain, reported that this strategy could be practiced globally to change how heart attacks are treated. People currently don’t receive medication before an angioplasty, the routine treatment for removing the blockage that causes a heart attack.
Borja Ibáñez, MD, PhD, head of the Experimental Cardiology Group at Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) in Spain and clinical cardiologist at the Hospital Clínico San Carlos in Spain, was the joint lead investigator of this study along with Valentín Fuster, MD, PhD, general director of CNIC, who also serves as director of Mount Sinai Heart and physician-in-chief at The Mount Sinai Medical Center.
A total of 270 patients experiencing a myocardial infarction (heart attack; when the coronary arteries are blocked) were recruited since 2010 in four of Spain’s regions: Madrid, Galicia, León and Cantabria. Patients were randomly assigned to receive either intravenous metoprolol or a placebo (fake) treatment when they were diagnosed with a heart attack in an ambulance.
Patients were given MRIs (magnetic resonance imaging) a week after their heart attack to measure their damaged heart tissue. MRIs were reviewed at the central CNIC lab by cardiologists unaware of who received treatment and who didn’t.
They found that the 139 patients who received metoprolol had 20 percent less heart tissue damage than those who didn’t get the medicine.
Metoprolol costs less than $3 per treatment. According to researchers, patients with less damage to heart tissue are less likely to need costlier treatments like an implantable defibrillator (a pager-sized device implanted in the chest) or require extended hospitalization. Researchers are conducting a cost-effective analysis to assess the potential savings.
Hospitals in Spain participating in the METOCARD-CNIC trial included Hospital Clínico San Carlos, Hospital de La Princesa, Hospital 12 de Octubre, Hospital Puerta de Hierro, and Hospital Quirón (Madrid), Hospital Meixoeiro (Galicia), Hospital de León (León) and Hospital Marqués de Valdecilla (Cantabria).
Researchers are now analyzing the effect of metoprolol on the heart. They plan to enroll more patients from around the world in the trial.
The study was published in the journal Circulation on October 1. It was conducted at CNIC in Spain and Icahn School of Medicine at Mount Sinai.
The study was funded by the Spanish Ministry of Economy and Competitiveness, a research grant from the CNIC and the designation of CNIC as a Severo Ochoa center in 2011. Support was also received from the Spanish Ministry of Health, Social Services and Equality, Philips, the Fundación Mutua Madrileña and from Pro-CNIC Foundation members, who donate to the CNIC.