- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05182970
Metformin and Prevention of Cardiovascular Events in Patients With Acute Myocardial Infarction and Prediabetes (MIMET) (MIMET)
The Myocardial Infarction and New Treatment With Metformin Study (MIMET) - a R-RCT to Study Metformin and the Prevention of Cardiovascular Events in Patients With Acute Myocardial Infarction and Newly Detected Prediabetes
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Anna Norhammar, MD, Prof.
- Phone Number: +46858701568
- Email: anna.norhammar@ki.se
Study Contact Backup
- Name: Viveca Ritsinger, MD, PhD
- Phone Number: +46372585000
- Email: viveca.ritsinger@ki.se
Study Locations
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Ljungby, Sweden, 341 35
- Recruiting
- Medicinkliniken, Ljungby Hospital
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Principal Investigator:
- Viveca Ritsinger, MD PhD
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Contact:
- Thomas Aronsson, Head of Clinic
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
I. AMI
II. Swedish citizens with a personal ID number ≥18 years and ≤80 years
III. Newly diagnosed prediabetes:
- HbA1c 42-47 mmol/mol or
- Capillary or venous fasting plasma glucose concentration 6.1-6.9 mmol/L or
- 2-hour post-load capillary glucose concentration 8.9-12.1 mmol/L or
- 2-h post-load venous plasma glucose concentration 7.8-11.0 mmol/L
- HbA1c <48 mmol/mol and 2-hour post-load capillary glucose concentration >12.1 mmol/L or 2-h post-load venous plasma glucose concentration >11.0 mmol/L (thus elevated 2-hour glucose levels in the diabetes range but without HbA1c levels diagnostic for diabetes)
IV. Naïve to metformin and other glucose lowering therapy
V. Signed informed consent
Exclusion Criteria:
I. Type 1 diabetes
II. Known type 2 diabetes
III. Indication for glucose lowering treatment
IV. Acute condition with high risk for volume depletion, circulatory shock, hypoxia
V. Serious illness, other than cardiovascular, with short life expectancy
VI. Renal failure (eGFR <60ml/min)
VII. Hepatic failure
VIII. Malignancy within the last year
IX. Contraindication or hypersensitivity to the study drug
X. Alcohol or drug abuse
XI. Pregnancy or breastfeeding
XII. Women of childbearing potential without adequate anticonception during any part of the study period
XIII. Previous hospitalisation for lactic acidosis
XIV. Predicted inability to comply with the study protocol
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Active Comparator: Metformin on top of standard care
Metformin will be prescribed by the Investigator at the study site and dispensed at pharmacy of choice by the patient.
Metformin will be recommended to be gradually titrated to minimize gastrointestinal side effects with a start dose of 500 mg 1x1 for 1 week and thereafter 500 mg 1x2 with an individualised target dose of 2000 mg daily depending on tolerability.
The goal is to a have minimal dose of 500 mg 1x2.
Patients will be informed to stop medication in events of sever nausea, vomiting or dehydration according to standard practice.
The threshold for metformin titration or adding another drug during follow-up is recommended to be assessed individually by the Investigator at the study site, responsible for the patient.
Patients with eGFR <60 cannot be included in the MIMET study.
If GFR is between 30-45 ml/min during the study, metformin should be reduced to 1000 mg daily.
Metformin is contraindicated if GFR <30 ml/min.
Standard care will be the same as in the control arm.
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Individualised target dose of 2000 mg daily depending on tolerability.
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No Intervention: Standard care alone
Standard care according to national guidelines.
In Sweden there is no pharmacological intervention recommended for individuals with prediabetes at present.
Standard care includes diet and life-style advice, which will be given to both groups in the same manner according to local routines, based on the present guidelines.
Secondary preventive treatment includes physical activity, participating in exercise program, dietary habits, BMI and or waist circumference, smoking and EQ-5D will be followed in accordance with the routinely reported SWEDEHEART-SEPHIA variables.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to major CV event
Time Frame: Estimated follow-up for each patient is 1-4 years
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Major CV event; a composite endpoint of first of all-cause death or main diagnosis of MI, heart failure or stroke (reported in SWEDEHEART, the National Patient Register and the Cause of Death Register).
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Estimated follow-up for each patient is 1-4 years
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to the composite endpoint CV death, main diagnosis of MI, heart failure or stroke.
Time Frame: Estimated follow-up for each patient is 1-4 years
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Time to first event included in the composite endpoint CV death, main diagnosis of MI, heart failure or stroke.
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Estimated follow-up for each patient is 1-4 years
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Time to the composite endpoint of all-cause death, main diagnosis of MI, stroke and revascularisation (CABG or PCI >4 months after the index AMI).
Time Frame: Estimated follow-up for each patient is 1-4 years
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Time to first event included in the composite endpoint of all-cause death, main diagnosis of MI, stroke and revascularisation (CABG or PCI >4 months after the index AMI).
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Estimated follow-up for each patient is 1-4 years
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All-cause death
Time Frame: Estimated follow-up for each patient is 1-4 years
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Time to all-cause death
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Estimated follow-up for each patient is 1-4 years
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CV death
Time Frame: Estimated follow-up for each patient is 1-4 years
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Time to CV death
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Estimated follow-up for each patient is 1-4 years
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Hospitalisation with MI
Time Frame: Estimated follow-up for each patient is 1-4 years
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Time to readmission for MI.
Hospital admission for MI during day 0-30 after index AMI will be excluded
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Estimated follow-up for each patient is 1-4 years
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Hospitalisation with stroke
Time Frame: Estimated follow-up for each patient is 1-4 years
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Time to hospitalisation for stroke (main diagnosis)
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Estimated follow-up for each patient is 1-4 years
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Hospitalisation with heart failure
Time Frame: Estimated follow-up for each patient is 1-4 years
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Time to hospitalisation for heart failure (main diagnosis)
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Estimated follow-up for each patient is 1-4 years
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New cancer diagnosis
Time Frame: Estimated follow-up for each patient is 1-4 years
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Time to new cancer diagnosis defined as the first occurrence of any cancer in the National Patient Register
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Estimated follow-up for each patient is 1-4 years
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Initiation of any glucose lowering therapy
Time Frame: Estimated follow-up for each patient is 1-4 years
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Time to initiation of any glucose lowering therapy (ATC code A10 in the Prescribed Drug Register, excluding randomisation to metformin)
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Estimated follow-up for each patient is 1-4 years
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Diabetes diagnosis
Time Frame: Estimated follow-up for each patient is 1-4 years
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Defined as diabetes diagnosis in National Patient Register and/or prescribed glucose lowering treatment in the Prescribed Drug Register excluding randomisation to metformin in the active treatment arm
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Estimated follow-up for each patient is 1-4 years
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Serious Adverse Events
Time Frame: Estimated follow-up for each patient is 1-4 years
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Number of Serious Adverse Events with at least a possible relationship to the study medication
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Estimated follow-up for each patient is 1-4 years
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Lactic acidosis (E11.1D)
Time Frame: Estimated follow-up for each patient is 1-4 years
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Number of events of lactic acidosis
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Estimated follow-up for each patient is 1-4 years
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Hypoglycaemia
Time Frame: Estimated follow-up for each patient is 1-4 years
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Number of events of hypoglycaemia
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Estimated follow-up for each patient is 1-4 years
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Anna Norhammar, MD, Prof., Karolinska Institutet
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Ischemia
- Pathologic Processes
- Necrosis
- Myocardial Ischemia
- Heart Diseases
- Cardiovascular Diseases
- Vascular Diseases
- Glucose Metabolism Disorders
- Metabolic Diseases
- Endocrine System Diseases
- Diabetes Mellitus
- Hyperglycemia
- Myocardial Infarction
- Infarction
- ST Elevation Myocardial Infarction
- Prediabetic State
- Glucose Intolerance
- Non-ST Elevated Myocardial Infarction
- Hypoglycemic Agents
- Physiological Effects of Drugs
- Metformin
Other Study ID Numbers
- 2019-05382
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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