6/28/23, 12:15 AM COMMIT Pathway Feedback Search Clinical Topics Home Studies COMMIT COMMIT Disease Disease Non-ST-elevation myocardial inf ST-elevation myocardial infarction Trial question What is the role of metoprolol in patients suspected of acute myocardial infarction? Study design Multi-center Double blinded RCT Population Characteristics of study participants 28.0% female N = 45852 72.0% male 45852 patients (12759 female, 33093 male) Inclusion criteria: patients suspected of acute myocardial infarction Key exclusion criteria: scheduled for primary PCI, life-threatening disease, persistently low BP, low HR, heart block, or cardiogenic shock Interventions N=22929 metoprolol (up to 15 mg IV then 200 mg oral daily) N=22923 placebo (matching placebo) Primary outcome Death, reinfarction, or cardiac arrest 9.9 % 9.9 9.4 7.4 % 5.0 % https://web.pathway.md/studies/recqSeWcTcx0cn7vS 1/2 6/28/23, 12:15 AM COMMIT Pathway 2.5 % No significant difference 0.0 % Metoprolol Placebo No significant difference in death, reinfarction, or cardiac arrest (9.4% vs. 9.9%; OR 0.96, 96% CI 0.9 to 1.01) Secondary outcomes No significant difference in death (7.7% vs. 7.8%; OR 0.99, 99% CI 0.92 to 1.05) Significant decrease in reinfarction (2% vs. 2.5%; OR 0.82, 95% CI 0.72 to 0.92) Significant decrease in VF (2.5% vs. 3%; OR 0.83, 95% CI 0.75 to 0.93) Conclusion In patients suspected of acute myocardial infarction, metoprolol was not superior to placebo with respect to death, reinfarction, or cardiac arrest. Reference Chen ZM, Pan HC, Chen YP et al. Early intravenous then oral metoprolol in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet. 2005 Nov 5;366(9497):1622-32. Open reference URL https://web.pathway.md/studies/recqSeWcTcx0cn7vS 2/2