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NCT Number: NCT07773272

Cardiovascular-kidney-metabolic (CKM)-Guided Therapy for Patients After Acute Coronary Syndrome

Patients with a history of myocardial infarction are at significantly increased risk of recurrent cardiovascular events. Despite established clinical guidelines, secondary preventive care is often initiated too late, inadequate in intensity or incomplete in application. As a result, important opportunities to prevent serious outcomes are missed.

The aim of this project is to investigate whether rapid, guideline-based treatment following myocardial infarction leads to improved patient outcomes. The study protocol is based on current clinical guidelines and targets key domains including diabetes, hypertension, and hypercholesterolemia. Outcomes of patients treated according to the study protocol will be compared to those receiving standard care. Primary endpoints include major adverse cardiac- and cerebrovascular events within a 24-month follow-up period.

The investigators hypothesize that rapid, guideline-based intervention will result in improved risk factor management, leading to a reduction in cardiovascular events and mortality. For patients, this may translate into improved health, quality of life and life expectancy. This project aims to deliver a practical protocol for effective secondary prevention in clinical practice, which is expected to reduce healthcare utilization in the long term. With this initiative, the investigators seek to take a significant step toward improving post-myocardial infarction care and contributing to sustainable cardiovascular healthcare.

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Key information

Conditions

Acute Coronary Syndrome (ACS) Undergoing Percutaneous Coronary Intervention (PCI) Acute Coronary Syndrome Cardiovascular Diseases Cardiovascular Risk Management Diabete Mellitus Diabetes Mellitus Endocrine System Diseases Glucose Metabolism Disorders Heart Diseases Hypercholerolemia Hypertension Metabolic Diseases Myocardial Ischemia Nutritional and Metabolic Diseases Vascular Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Cardiology

Heerlen, Limburg, 6419 PC, Netherlands

Location status: Recruiting

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age > 18 years
  • Hospitalised with acute coronary syndrome
  • Underwent percutaneous coronary intervention

Exclusion criteria

  • Acute coronary syndrome secondary to other diseases
  • Life expectancy < 1 year based on the clinician's expertise

Treatment and study plan

Rapid ESC-guideline based secondary prevention following myocardial infaction

Drug

In the intervention group, patients will be treated according to a rapid ESC-guideline-based protocol. This approach will target:

  • Optimal pharmacological treatment, including:
  • Lipid-lowering
  • Antihypertensive
  • Diabetic, such sodium-glucose co-transporter 2 inhibitors (SGLT-2 inhibitors)
  • Glucagon-like peptide-1 agonists (GLP-1 agonists)

Primary outcomes

  1. MACCE within 2 years after the ACS and PCI

    Time frame: From enrollment to end of 2 year follow-up

    The occurrence of major adverse cardiac- and cerebrovascular events (MACCE) defined as the composite of all cause death, myocardial infarction, (ischemic or hemorrhagic) CVA, and ischemia-driven revascularization at 24 months.

Secondary outcomes

  1. 30 days endpoints checklist

    Time frame: From discharge till 30 days after discharge

    Prevelance of the following endpoints with 30 days after discharge:

    • Death due to any cause
    • Cardiovascular mortality
    • Reacurent acute coronary syndrom
    • Ischemia-driven revascularization
    • Ischemic CVA
    • Haemorrhagic CVA
    • Uplanned cardiovascular hospital readmission
    • New onset of diabetes mellitus type 2
    • New onset of peripheral arterial disease
    • Sustained decline of eGFR of 50% for more than 3 months based on eGFR lab value

    Measures will be defined as either present or absent and collected via medical record.

  2. Quality of life survey at 30 days

    Time frame: 30 days after discharge

    Patients recieve a quality of life survey at 30 days after discharge. This is done with a SF-36 questionnaire

  3. 1 year endpoints checklist

    Time frame: Between 30 days and 1 year after discharge

    Prevelance of the following endpoints 1 year after discharge:

    • Death due to any cause
    • Cardiovascular mortality
    • Reacurent acute coronary syndrom
    • Ischemia-driven revascularization
    • Ischemic CVA
    • Haemorrhagic CVA
    • Uplanned cardiovascular hospital readmission
    • New onset of diabetes mellitus type 2
    • New onset of peripheral arterial disease
    • Sustained decline of eGFR of 50% for more than 3 months

    Measures will be defined as either present or absent and collected via medical record.

  4. Quality of life survey at 1year

    Time frame: 1 year after discharge

    Patients recieve a quality of life survey at 1year after discharge. This is done with a SF-36 questionnaire

  5. 2 year endpoints checklist

    Time frame: Between 1 en 2 years after discharge

    Prevelance of the following endpoints 2 years after discharge:

    • Death due to any cause
    • Cardiovascular mortality
    • Reacurent acute coronary syndrom
    • Ischemia-driven revascularization
    • Ischemic CVA
    • Haemorrhagic CVA
    • Uplanned cardiovascular hospital readmission
    • New onset of diabetes mellitus type 2
    • New onset of peripheral arterial disease
    • Sustained decline of eGFR of 50% for more than 3 months

    Measures will be defined as either present or absent and collected via medical record.

  6. Quality of life survey at 2 years

    Time frame: 2 years after discharge

    Patients recieve a quality of life survey at 2 years after discharge. This is done with a SF-36 questionnaire

Study contacts

Contact information is provided by the study sponsor or research team.

Stan Toonen, MSc

CONTACT

[email protected]

+318854597522

Sponsors and collaborators

Lead sponsor

Zuyderland Medisch Centrum

Other

Registry information

Acronym: SLIM-3

Important dates

Study start
2026
Primary completion
2029
Study completion
2029
First posted
Aug 19, 2026
Registry last updated
Aug 19, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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