EARLY-BAMI outcomes show the endovenous administration of metropol before primary PCI does not reduce infarct size.

This double blind study randomized 683 STEMI patients within 12 hours of symptom onset to endovenous metropol (two 5 mg bolus, the first in the ambulance and the second before PCI) vs. placebo.

Primary end point was infarct size by MRI at 30 days, that resulted similar between the two groups (15.3% vs 14.9%; p=0.62).

Originally, the study was designed to measure infarct size based on troponin T peak, but to reduce the study sample, the end point was switched to MRI, which also allows more precision.

The adverse events incidence was also similar between the groups, with the sole exception of those receiving beta-blockers, less prone to malignant arrhythmias (3.6% vs 6.9%; p=0.050).