LIVEBETTER: A Trial Comparing Medications in Older Adults With Stable Angina and Multiple Chronic Conditions

Launched by YALE UNIVERSITY · Mar 23, 2023

Keywords

ClinConnect Summary

The LIVEBETTER trial is studying how effective and tolerable certain medications are for older adults who have stable angina (chest pain caused by reduced blood flow to the heart) and multiple chronic conditions, such as diabetes or high blood pressure. The trial focuses on two common types of medications, called beta-blockers and calcium channel blockers, which are used to help manage symptoms of stable ischemic heart disease. Researchers want to see how well these medications work in older adults, who often have other health issues that can complicate treatment.

To participate in this trial, you need to be at least 70 years old (or 65 if you belong to certain racial or ethnic groups), have a diagnosis of stable angina, and be starting treatment with these specific medications. You'll also need to have at least two other chronic health conditions. If you join, you can expect regular check-ups and follow-up appointments to monitor your health and how well the medications are working for you. Caregivers can also be involved in the study, as long as they are 18 or older and have a close connection to the participant. This trial is currently recruiting participants, so if you or someone you know fits the criteria, consider reaching out for more information.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • OLDER ADULTS WITH SIHD AND MCC
• • Age ≥70 years; ≥65 years for underrepresented minorities (URM) of black race or Hispanic ethnicity
• • ≥ 2 Multiple Chronic Conditions as defined by Centers for Medicare and Medicaid Services (CMS)
• * Diagnosis of Symptomatic Stable Ischemic Heart Disease with plans to initiate medical therapy identified by at least one of the following:
• • 1. positive non-invasive functional or anatomic testing suggestive of obstructive coronary artery disease
• • 2. coronary angiography with stenosis ≥70% in a coronary artery ≥2 mm in diameter or
• • ≥50% stenosis of left main
• • 3. Invasive coronary angiography with positive physiologic testing in at least one vessel (FFR ≤ 0.80 or iFR ≤0.89)
• • CAREGIVERS
• • Age ≥ 18 years
• • Identified as caregiver of LIVEBETTER participant
• Exclusion Criteria:
• • OLDER ADULTS WITH SIHD AND MCC
• • Current taking beta-blocker or calcium channel blocker\*
• * Contraindication to beta-blockers or calcium channel blockers including:
• • 1. significant hypotension
• • 2. high grade AV block
• • 3. severe symptomatic bradycardia
• • 4. severe obstructive lung disease
• • Documented intolerance to beta-blockers or calcium channel blockers
• • Probable or definite high-risk coronary artery disease including unrevascularized left main disease and/or unrevascularized multi-vessel disease including the proximal left anterior descending (LAD) artery with plans for immediate complete revascularization
• • Plans for complete revascularization within 2 weeks
• * Clear indication for beta-blockers or calcium channel blockers including:
• • 1. Diagnosis of acute coronary syndrome (ACS) with reduced ejection fraction within past year
• • 2. Heart failure with reduced ejection fraction (HFrEF) within past year
• • Actively participating in another clinical trial involving an investigational medication or device
• • Primary language other than English or Spanish
• • Inability to complete follow-up (e.g. life expectancy \<12 months, impaired decision-making determined by validated instrument)
• • Previously enrolled in LIVEBETTER
• • Refused informed consent
• • CAREGIVERS
• • Professional caregiver (i.e. not a relative or close friend of the participant)
• • Primary language other than English or Spanish
• • Inability to complete follow-up
• • Previously enrolled in LIVEBETTER
• • Refused informed consent