Ambulance steroid shot may cut heart attack deaths, large trial underway

NCT ID NCT07478003

Disease control Sponsor: Thomas Engstrom Source: ClinicalTrials.gov ↗

First seen Jun 27, 2026 · Last updated Jun 27, 2026

Summary

This phase 3 trial tests whether a single high dose of the steroid methylprednisolone, given in the ambulance before opening the blocked artery, can reduce deaths in people having a major heart attack (STEMI). About 5,200 adults will be randomly assigned to receive either the steroid or a placebo during transport. The main goal is to see if the treatment lowers the risk of dying from any cause over the following years.

What this could mean

Our plain-language read of the trial. This is informational only, not medical advice or a prediction.

Active substance: Methylprednisolone (a steroid drug)
What this could lead to: If it works, this could become a standard prehospital treatment to reduce deaths and heart failure after a major heart attack.
What could go wrong: This is a large phase 3 trial, but earlier phase 2 results only showed trends, not proof. Steroids have risks like infection and may not improve survival.

This is an AI summary of the original study and may miss details. Read our disclaimer.

Study facts

What this study's own registry entry says, in plain language.

Phase

Phase 3

Large-scale testing in a bigger group. Usually the last step before a treatment can be approved.

Participants

About 5,204 people

The number the study aims to enrol. It can still change while the study runs.

Started

Apr 2026

Expected to finish

Apr 2036

An estimate. End dates often move.

Lead sponsor

Other sponsor

The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

18 years and older

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Age ≥18 years including fertile women * Acute onset of chest pain with \< 24 hours duration * STEMI as characterized on electrocardiogram (ECG) by one of the following: 1. at least two contiguous leads with ST-segment elevation ≥2.5 mm in men \< 40 years, ≥2 mm in men ≥40 years, or ≥1.5 mm in women in leads V2-V3 and/or ≥1 mm in the other leads, 2. presumed new left bundle branch block with ≥1 mm concordant ST-segment elevation in leads with a positive QRS complex, or concordant ST-segment depression ≥1 mm in V1-V3, or discordant ST-segment elevation ≥5 mm in leads with a negative QRS complex 3. Isolated ST depression ≥0.5 mm in leads V1-V3 indicating posterior acute myocardial infarction (AMI) 4. ST-segment depression ≥1 mm in eight or more surface leads, coupled with ST-segment elevation in aVR and/or V1 suggesting left main-, or left main equivalent- coronary obstruction Exclusion Criteria: * Suspected other type I acute myocardial infarction at time of potential randomization * Initial presentation with cardiac arrest (out of hospital cardiac arrest) * Known allergy to glucocorticoid

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Conditions

The condition(s) this trial relates to.

ST-elevation myocardial infarction

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

Stemi - ST elevation myocardial infarction

How to take part

Only the study team decides who joins. These are the ways to reach them.

The places running it

4 sites. The list below names each one and where it is.
The official record

ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.

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A doctor treating you

A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.

Ambulance steroid shot may cut heart attack deaths, large trial underway

What the study statuses mean