Biomarker-guided Management Following a Heart Attack

After a heart attack, people are at ongoing risk of further cardiac events over the following months and years. A simple blood test can detect whether the heart is still under stress — elevated levels of certain proteins in the blood (called biomarkers) indicate that the heart muscle may be strained. This trial is testing whether using these biomarkers to guide treatment decisions — specifically, more aggressive medication adjustment — can reduce the risk of another heart attack or hospitalisation. Participants will be randomly assigned to either usual follow-up care or a biomarker-guided approach. In the biomarker group, blood tests will be used to identify which patients are at higher risk, and those patients will have their medications (such as ACE inhibitors and beta-blockers) more carefully adjusted to better protect their heart. The study will follow participants for 18 months and compare rates of death and cardiovascular re-admission between the two groups. You may be eligible if you are 18 or older, were discharged from hospital in the past 1 to 12 months after a heart attack (acute coronary syndrome), and are able to provide consent. People with known very poor heart pump function, severe valve disease, end-stage kidney disease, or a life-limiting illness are not eligible. This study is enrolling patients in New Zealand and offers a promising pathway to more personalised heart care.