This study is looking at how a medication called beta-blockers (metoprolol) affects patients with a heart attack (STEMI) who are in the cardiac intensive care unit.
When patients are admitted to the unit, they will be randomly placed in one of two groups. One group will get the metoprolol medication, and the other will receive a placebo (a harmless pill that looks like the real medication). All other treatments will be the same for both groups.
During the study, which is 72 hours long, patients will be monitored for blood pressure, heart rate, and lactate levels alterations.
The main goal is to see if the medication helps improve patients condition or prevent it from getting worse. patients safety is a top priority, and if needed, the doctors can stop the study at any time if there are concerns.
Diagnosis of ST-segment elevation myocardial infarction (STEMI) confirmed by ECG, clinical signs, and coronary catheterization.
Post-catheterization patients classified as SCAI B upon admission to the unit, defined by the presence of tachycardia and/or hypotension without signs of hypoperfusion (i.e., normal lactate levels, normal capillary refill, preserved mental status, and adequate urine output >0.5 mL/kg/hour).
Age 18 years or older.
Mentally competent to provide informed consent, understand the study procedures, and comply with medical recommendations.
Pregnancy.
Inability to provide informed consent.
Evidence of pulmonary edema.
Bradycardia (heart rate <60 beats per minute).
Parallel
Metoprolol (MET)
DrugAdministration of metoprolol 25 mg twice daily
Plcacebo
DrugAdministration of matching placebo
Number of patients progressed from SCAI B to SCAI C
number of patients who progressed from SCAI B to SCAI C as measured by - Serum lactate levels \> mmol/L urinary output \> 0.5 ml/kg/hour slow capillary filling Change in mental status
Rate of in-hospital mortality
The mortality rate of patients during index admission
Need for Mechanical ventilation
The rate of patients that will require mechanical ventilation
Minor adverse events
minor events including tachyarrhythmia, bradyarrhythmia, AV blocks
Hospitalizion duration
Time of index hospitalization
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