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Myocardial InfarctionPhase 4REMINDERNCT01176968

Impact Of Eplerenone On Cardiovascular Outcomes In Patients Post Myocardial Infarction

A Phase 4 study testing Eplerenone in people with Myocardial Infarction, run by Pfizer's Upjohn has merged with Mylan to form Viatris Inc. at 75 sites in 11 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Administration of eplerenone within 24 hours of onset of symptoms of myocardial infarction, in patients without heart failure, reduces cardiovascular mortality / morbidity. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Myocardial Infarction
What is being tested?
Eplerenone
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
1,012 participants
Where
75 sitesin 11 countries
Study dates
Sep 2010to Oct 2012
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Subjects must have experienced a myocardial infarction (STEMI) within the previous 24 hours confirmed by symptoms and ECG.

Who cannot join

  • Subjects with a known low ejection fraction of less than 40% or any previous history of heart failure.
  • Subjects treated with eplerenone or other aldosterone antagonists within the past 1 month.
  • The subject has uncontrolled hypotension (SBP<90mmHg).
  • Subjects with eGFR ≤30ml/min (based on admission serum creatinine and the MDRD formula) or serum creatinine ≥220µmol/L.

Trial locations and contacts

75 sites in 11 countries.

75 sites in 11 countries

Germany13 sites
  • Universitaets-Herzzentrum Freiburg Bad Krozingen

    Bad Krozingen, 79189

  • Charite - Universitaetsmedizin Berlin

    Berlin, 12200

  • Universitätsklinikum Bonn

    Bonn, 53127

  • Klinikum Links der Weser gGmbH

    Bremen, 28277

  • Sankt Johannes Hospital Medizinische Klinik I

    Dortmund, 44137

  • Sankt Johannes Hospital

    Dortmund, 44137

  • Medizinische Fakultaet Carl Gustav Carus Technische Universitaet Dresden

    Dresden, 01309

  • Georg-August-Universitaet Goettingen, Zentrum f. Innere Medizin / Kardiologie u. Pneumologie

    Göttingen, 37075

  • Universitaeres Herzzentrum Hamburg

    Hamburg, 20246

  • Medizinische Hochschule Hannover

    Hanover, 30625

  • St. Vincenz Krankenhaus

    Limburg, 65549

  • Universitaetsmedizin der Johannes Gutenberg-Universitaet Mainz

    Mainz, 55131

  • Staedtisches Klinikum Muenchen GmbH Klinikum Neuperlach

    Munich, 81737

Other trials in Germany

Canada11 sites
  • Centre de Sante et de Services Sociaux de Chicoutimi (CSSSC) (Complexe Hospitalier de la Sagamie)

    Chicoutimi, Quebec, G7H 5H6

  • ECOGENE-21 / Centre de sante et de services sociaux de Chicoutimi

    Chicoutimi, Quebec, G7H 7P2

  • University of Alberta Hospital

    Edmonton, Alberta, T6G 2B7

  • Walter C Mackenzie Health Sciences Centre (WCM)

    Edmonton, Alberta, T6G 2B7

  • Centre Hospitalier Universitaire de Sherbrooke, Hopital Fleurimont

    Sherbrooke, Quebec, J1H 5N4

  • Health Sciences Center, Eastern Health

    St. John's, Newfoundland and Labrador, A1B 3V6

  • Sunnybrook Health Sciences Centre

    Toronto, Ontario, M4N 3M5

  • St. Michael's Hospital

    Toronto, Ontario, M5B1W8

  • Diamond Health Care Centre (DHCC)

    Vancouver, British Columbia, V5Z 1M9

  • Vancouver General Hospital - Centennial Pavilion

    Vancouver, British Columbia, V5Z 1M9

  • Vancouver General Hospital, Vancouver Coastal Health Authority

    Vancouver, British Columbia, V5Z 1M9

Other trials in Canada

United Kingdom10 sites
  • City Hospital

    Birmingham, B18 7QH

  • Blackpool Victoria Hospital NHS Trust , Cardiac Research ,Lancashire Cardiac Centre

    Blackpool, Lancashire, FY3 8NR

  • Academic cardiology Unit

    Cottingham Hull, HU16 5JQ

  • University Hospitals Coventry and Warwickshire NHS Trust

    Coventry, CV2 2DX

  • Ninewells Hospital and Medical School

    Dundee, DD1 9SY

  • Edinburgh Royal Infirmary

    Edinburgh, Lothian, EH16 4SA

  • The Queens Medical Research Institute- University of Edinburgh

    Edinburgh, EH16 4TJ

  • University Hospital of Leicester (UHL) NHS Trust

    Leicester, LE3 GQP

  • Clinical Trials Unit Morriston Hospital

    Swansea, Wales, SA6 6NL

  • Clinical Trials Unit, Morriston Hospital

    Swansea, SA6 6NL

Other trials in United Kingdom

France9 sites
  • Service Cardiologie, Centre Hospitalier de Cannes

    Cannes, 06401

  • Hôpital Henri Mondor - Pysiologie explorations fonctionnelles

    Créteil, 94010

  • Hôpital Henri Mondor

    Créteil, 94010

  • Chu du Bocage - Centre de Cardiologie

    Dijon, Cedex, 21034

  • Centre de Cardiologie d'Evecquemont

    Évecquemont, 78740

  • Service Cardiologie Hopital Robert Boulin

    Libourne, 33500

  • Hopital De La Pitie Salpetriere

    Paris, Cedex, 75013

  • Cardiologie Interventionnelle

    Pessac, 33604

  • Chu Rangueil Service de Cardiologie, A - Bat H1

    Toulouse, Cedex 4, 31403

Other trials in France

Czechia7 sites
  • Fakultni nemocnice Brno

    Brno, 62500

  • Fakultni nemocnice Hradec Kralove

    Hradec Králové, 500 05

  • Fakultni nemocnice Hradec Kralove

    Hradec Králové, 50005

  • I.Interni klinika-kardiologie FN Olomouc

    Olomouc, 775 20

  • I. Interni klinika - kardiologie FN Olomouc

    Olomouc, 77520

  • Klinika kardiologie IKEM

    Prague, 140 21

  • Nemocnice Na Homolce - kardiologicke oddeleni

    Prague, 150 30

Other trials in Czechia

Spain7 sites
  • "Hospital Clinic i Provincial de Barcelona,Instituto Clinic del Torax

    Barcelona, 08036

  • Hospital del Mar.

    Barcelona, 8003

  • Hospital Del Sas de Jerez de La Frontera

    Jerez de la Frontera, Cadiz, 11407

  • HOSPITAL CLINICO SAN CARLOS- Universidad Complutense de Madrid

    Madrid, 28040

  • Hospital Universitario de La Paz

    Madrid, 28046

  • Hospital Universitari Son Espases

    Palma de Mallorca, 07010

  • Hospital General Universitario de Valencia

    Valencia, 46014

Other trials in Spain

Slovakia5 sites
  • Stredoslovensky ustav srdcovych a cievnych chorob, a.s.

    Banská Bystrica, 974 01

  • Narodny ustav srdcovych a cievnych chorob, a.s.

    Bratislava, 833 48

  • Univerzitna nemocnica Martin

    Martin, 036 59

  • Kardiocentrum Nitra, s.r.o.

    Nitra, 949 01

  • Vseobecna nemocnica Rimavska Sobota

    Rimavská Sobota, 979 12

Other trials in Slovakia

Hungary4 sites
  • Budai Irgalmasrendi Korhaz, Kardiologia

    Budapest, 1027

  • Petz Aladar Megyei Oktato Korhaz, Kardiologiai Osztaly

    Győr, 9024

  • Josa Andras Oktato Korhaz Egeszsegugyi Szolgaltato Nonprofit Kft., Kardiologia

    Nyíregyháza, 4400

  • Zala Megyei Korhaz, Kardiologia

    Zalaegerszeg, 8900

Other trials in Hungary

Poland4 sites
  • Katedra i Klinika Kardiologii i Chorob Wewnetrznych

    Bydgoszcz, 85-094

  • Oddzial Kardiologiczny Wojewodzki Szpital Specjalistyczny w Olsztynie

    Olsztyn, 10-561

  • Centrum Kardiologii Inwazyjnej, Elektroterapii i Angiologii NZOZ w Oswiecimiu G.V.M CARINT Sp. zo.o.

    Oświęcim, 32-600

  • Oddzial Kardiologiczny Wojewodzki Szpital Specjalistyczny We Wroclawiu

    Wroclaw, 51-124

Other trials in Poland

Greece3 sites
  • General Hospital of Athens "Georgios Gennimatas"

    Athens, 11527

  • General Hospital of Attiki KAT

    Athens, 14561

  • University General Hospital of Patra

    Rio Patra, 26500

Other trials in Greece

Netherlands2 sites
  • Onze Lieve Vrouwe Gasthuis, Locatie Oosterpark

    Amsterdam, 1091 AC

  • St. Antonius Ziekenhuis

    Nieuwegein, 3435 CM

Other trials in Netherlands

About this study

Official title: A Double-blind, Randomized, Placebo-controlled Trial Evaluating The Safety And Efficacy Of Early Treatment With Eplerenone In Patients With Acute Myocardial Infarction

Administration of eplerenone within 24 hours of onset of symptoms of myocardial infarction, in patients without heart failure, reduces cardiovascular mortality / morbidity.

Being tested
Eplerenone, Placebo
Keywords
Eplerenone, myocardial infarction, mortality, morbidity
Medical subject headings
Myocardial Infarction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • EplerenoneDrug

    Also called Inspra

    Maximum dose of 2x25 mg film coated tablets per day for the duration of the study (approximately 18 months maximum). Lower doses may be administered determined by blood biochemistry data.

  • PlaceboDrug

    Matching placebo tablets

Study groups in NCT01176968
Study groupRoleWhat they receive
Eplerenone plus standard of careExperimentalNot described
Receives: Drug: Eplerenone
Placebo plus standard of carePlacebo comparatorMatching placebo for eplerenone 25mg film coated tablets.
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. First Event of Cardiovascular Mortality, Re-hospitalization or Extended Initial Hospital Stay Due to Diagnosis of Heart Failure, Sustained Ventricular Tachycardia or Fibrillation, Ejection Fraction ≤40% or BNP Above Age Adjusted Cut Off

    Cardiovascular mortality is defined as any mortality adjudicated as death due to sudden cardiac death, myocardial infarction (MI), worsening heart failure, cardiac arrhythmia, other cause (such as pulmonary embolism, peripheral arterial disease [PAD], etc.). Hospitalization due to congestive heart failure (CHF) and requires extended hospital stay or frequent visits to emergency room, observation unit or in-patient care, due to CHF as the primary or secondary diagnosis supported by a discharge report or clinical summary for hospitalization as determined by the endpoint adjudication committee (EAC). A composite of time to first event of cardiovascular mortality (CV), re-hospitalization or extended initial hospital stay due to diagnosis of heart failure, sustained ventricular tachycardia or fibrillation, ejection fraction ≤40% after 1 month or BNP >200 pg/mL or NT-proBNP >450 pg/mL (age <50 years); >900 pg/mL (age 50 to 75 years) or >1800 pg/mL (age >75 years) after 1 month.

    Measured: 0-24 months

Secondary outcomes (13)
  1. Cardiovascular Mortality

    The occurrence of cardiovascular mortality from randomization. Time-to-event analyses were measured from the date of randomization. A subject who did not experience the endpoint(s) of interest was censored on the last day the subject was confirmed by the investigator to be endpoint-free. The time-to-event distributions were summarized by treatment group using Kaplan-Meier estimates of cumulative incidence.

    Measured: 0-24 months

  2. Diagnosis of Heart Failure

    The occurrence of first diagnosis of heart failure from the date of randomization. Time-to-event analyses were measured from the date of randomization, and a subject who did not experience the endpoint(s) of interest was censored on the last day the subject was confirmed by the investigator to be endpoint-free. The time-to-event distributions were summarized by treatment group using Kaplan-Meier estimates of cumulative incidence.

    Measured: 0-24 months

  3. First and Each Subsequent Episode (After an Event Free Interval of ≥ 48 Hours) of Sustained Ventricular Tachycardia or Ventricular Fibrillation.

    The occurrence of first and each subsequent episode (after an event-free interval of ≥ 48 hours) of sustained ventricular tachycardia or ventricular fibrillation. Time-to-event analyses were measured from the date of randomization. A subject who did not experience the endpoint(s) of interest was censored on the last day the subject was confirmed by the investigator to be endpoint-free. The time-to-event distributions were summarized by treatment group using Kaplan-Meier estimates of cumulative incidence.

    Measured: 0-24 months

  4. First Recorded Ejection Fraction (EF) of ≤40% (Recorded 1 Month or Later Post-randomization).

    The occurrence of first recorded EF ≤40% (recorded 28 days or later post-randomization). Time-to-event analyses were measured from the date of randomization. A subject who did not experience the endpoint(s) of interest was censored on the last day the subject was confirmed by the investigator to be endpoint-free. The time-to-event distributions were summarized by treatment group using Kaplan-Meier estimates of cumulative incidence.

    Measured: 0-24 months

  5. Brain (B-type) Natriuretic Peptide (BNP) >200 pg/mL or NT-proBNP >450, >900 or >1800 pg/mL for Ages <50 Years, 50-75 Years and >75 Years, Respectively (Recorded 1 Month or Later Post-randomization).

    The occurrence of first occurrence of BNP >200 pg/mL or NT-proBNP >450, >900 or >1800 pg/mL for ages <50 years, 50 to 75 years and >75 years, respectively (recorded 28 days or later post-randomization). Time-to-event analyses were measured from the date of randomization. A subject who did not experience the endpoint(s) of interest was censored on the last day the subject was confirmed by the investigator to be endpoint-free. The time-to-event distributions were summarized by treatment group using Kaplan-Meier estimates of cumulative incidence.

    Measured: 0-24 months

  6. Decision to Provide an Implantable Cardioverter Defibrillator (ICD) or Cardiac Resynchronization Therapy (CRT).

    The decision to provide an ICD or CRT. Time-to-event analyses were measured from the date of randomization. A subject who did not experience the endpoint(s) of interest was censored on the last day the subject was confirmed by the investigator to be endpoint-free. The time-to-event distributions were summarized by treatment group using Kaplan-Meier estimates of cumulative incidence.

    Measured: 0-24 months

  7. Second or Subsequent Non-fatal Myocardial Infarction (MI).

    The occurrence of second or subsequent nonfatal MI. Time-to-event analyses were measured from the date of randomization. A subject who did not experience the endpoint(s) of interest was censored on the last day the subject was confirmed by the investigator to be endpoint-free. The time-to-event distributions were summarized by treatment group using Kaplan-Meier estimates of cumulative incidence.

    Measured: 0-24 months

  8. Electrocardiogram Q Wave to the End of the S Wave Corresponding to Ventricle Depolarization (QRS) Duration at 6 Months Post-randomization.

    Electrocardiogram Q wave to the end of the S wave corresponding to ventricle depolarization (QRS) duration at 6 months post-randomization. The continuous endpoints were assessed using analysis of covariance (ANCOVA) model, fitted with corresponding baseline and treatment. These were analyzed at 6 months based on last observation carried forward (LOCF) and also using all available data up to end of study.

    Measured: 6 months

  9. Left Atrial Diameter (LAD) (Recorded on Each Occasion an Echocardiogram is Conducted).

    LAD recorded each time an echocardiogram is conducted. The continuous endpoints were assessed using ANCOVA model, fitted with corresponding baseline and treatment. These were analyzed at 6 months based on LOCF and also using all available data up to end of study.

    Measured: 0-24 months

  10. Change in Serum Levels of Biomarkers (Aldosterone and Cortisol) at 6 Months Post-randomization.

    Change in serum levels of aldosterone and cortisol at 6 months post-randomization. The continuous endpoints were assessed using ANCOVA model, fitted with corresponding baseline and treatment. These were analyzed at 6 months based on LOCF and also using all available data up to end of study.

    Measured: 6 months

  11. Change in Serum Levels of Biomarkers (PIIINP, Galectin 3, and PINP) at 6 Months Post-randomization.

    Change in serum levels of PIIINP, Galectin 3, and PINP at 6 months post-randomization. The continuous endpoints were assessed using ANCOVA model, fitted with corresponding baseline and treatment. These were analyzed at 6 months based on LOCF and also using all available data up to end of study.

    Measured: 6 months

  12. Change in Serum Level of Biomarker (ICTP) at 6 Months Post-randomization.

    Change in serum level of ICTP at 6 months post-randomization. The continuous endpoint was assessed using ANCOVA model, fitted with corresponding baseline and treatment. It was analyzed at 6 months based on LOCF and also using all available data up to end of study.

    Measured: 6 months

  13. Change in Serum Level of Biomarker (Interleukin-6) at 6 Months Post-randomization.

    Change in serum level of Interleukin-6 at 6 months post-randomization. The continuous endpoint was assessed using ANCOVA model, fitted with corresponding baseline and treatment. It was analyzed at 6 months based on LOCF and also using all available data up to end of study.

    Measured: 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Aug 2010 (estimated)
  2. Study startSep 2010
  3. Primary completionOct 2012
  4. Study completionOct 2012

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
1,012 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01176968
Sponsor's protocol ID
A6141116
Other IDs
2010-019844-38, REMINDER
Acronym
REMINDER
Status last verified
Dec 2020
First submitted
4 Aug 2010
Last updated
22 Dec 2020
Data monitoring committee
Yes

Publications

  • Montalescot G, Pitt B, Lopez de Sa E, Hamm CW, Flather M, Verheugt F, Shi H, Turgonyi E, Orri M, Vincent J, Zannad F; REMINDER Investigators; REMINDER Investigators. Early eplerenone treatment in patients with acute ST-elevation myocardial infarction without heart failure: the Randomized Double-Blind Reminder Study. Eur Heart J. 2014 Sep 7;35(34):2295-302. doi: 10.1093/eurheartj/ehu164. Epub 2014 Apr 29.

    PubMed 24780614

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Eplerenone in people with Myocardial Infarction, run by Pfizer's Upjohn has merged with Mylan to form Viatris Inc. at 75 sites in 11 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 22 Dec 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 75 sites in Germany, Canada, United Kingdom, France, Czechia and 6 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 15 Aug 2016). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

First Event of Cardiovascular Mortality, Re-hospitalization or Extended Initial Hospital Stay Due to Diagnosis of Heart Failure, Sustained Ventricular Tachycardia or Fibrillation, Ejection Fraction ≤40% or BNP Above Age Adjusted Cut Off (time frame: 0-24 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01176968, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Dec 2020.

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