Metoprolol to Reduce Perioperative Myocardial Injury (ORION)
Heart Diseases

About this trial
This is an interventional treatment trial for Heart Diseases focused on measuring surgery, heart disease, metoprolol, myocardial injury, coronary artery disease
Eligibility Criteria
Inclusion Criteria
- Age >= 50 years
- Beta-blocker naïve [30 days prior to surgery]
Previously diagnosed CAD, or
- History of PVD, or
- CKD [eGFR ≤60ml/min], or
- History of positive stress test or
- At high risk for CAD (must meet at least 2 criteria):
i. Age >= 70 years ii. Hypertension iii. Diabetes requiring oral medication or insulin iv. Current smoker or some days smoker within the past 2 years
- Major non-cardiac, elective surgery under general anesthesia
Exclusion Criteria
Subjects will not be enrolled if any of the following criteria exist:
- History of stroke, or TIA
- Previously diagnosed carotid disease, i.e., either 70% unilateral or 50% bilateral carotid occlusion.
- Heart rate <=55bpm
- Congestive heart failure with New York Heart Association(NYHA) Functional Classification of III-IV or left ventricular heart failure with ejection fraction ≤50%
- Severe valvular regurgitation
- Second or third degree AV block without pacemaker
- Active asthma or COPD with symptoms or resolving symptoms on day of surgery
- Anemia [HB<=9g/dL]
- Allergy to beta-blockade drugs
- Unwilling or unable to give consent for participation
- Undergoing any carotid endarterectomy, endovascular, endoscopic, superficial, or ambulatory procedures
- Pregnancy or lactating women
- Prisoners
Sites / Locations
- University of Chicago Medicine
- Washington University School of Medicine
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Metoprolol
Placebo
Metoprolol group, 3-intravenous doses of 5mg metoprolol tartrate (over 15-minutes), and oral dose(s) of 25mg metoprolol approximately every 8 hours postoperatively for up to 3-days (or 72 hrs).
Placebo comparator group, up-to-three intravenous doses of placebo comparator (over 15-minutes), and oral dose(s) of a placebo comparator approximately every 8 hours postoperatively for up to 3-days (or 72 hrs).