Ivabradine in the Acute Management of Cardiogenic Shock

Recruiting now · Phase 3 · Has a placebo group

Conditions studied: Cardiogenic Shock Post Myocardial Infarction

In brief

Brief Summary: The IVASHOCK trial investigates whether ivabradine can achieve at least one-class improvement in SCAI cardiogenic shock classification compared to placebo, and evaluates its safety profile in patients with cardiogenic shock (CS). Primary Objectives: 1. To determine whether ivabradine improves SCAI shock classification by at least one class from baseline within 72 hours compared to placebo 2. To assess whether ivabradine facilitates earlier weaning from vasoactive and inotropic support compared to placebo Safety Endpoints: Adverse events monitored include: sinus node dysfunction, new-onset atrial fibrillation or atrial flutter, atrioventricular block, drug-related hypotension, and ventricular arrhythmia. Participant Schedule: Participants will receive ivabradine or placebo orally every 12 hours for 3 days. Hemodynamic and metabolic assessments will include: Arterial pH, central venous oxygen saturation (ScvO2), and serum lactate - every 6 hours on Day 1, then every 8 hours on Days 2 and 3 Heart rate, mean arterial pressure (MAP), vasoactive/inotropic support dose, and urine output - measured on the same timeline

Key facts

Study ID: NCT07714746
Run by: National Institute of Cardiovascular Diseases, Pakistan
People needed: 200
Starts: 2026-04-20
Expected to finish: 2027-05-31
Last updated by the study team: 2026-07-20

Who can join

Age: 18 and older, up to 75. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Patients aged 18-75 years diagnosed with STEMI complicated by cardiogenic shock (CS) as defined by SCAI shock classification > C:
Signs of Hypoperfusion including:
SBP <90 OR MAP <60 OR >30 mmHg drop from baseline AND drugs/device used to maintain BP above these targets
Cold, clammy extremities
Urine output <30 mL/h
pulmonary congestion (either crackles, congestion in chest X-ray or B-lines in lung US)
Mixed venous oxygen saturation ≤ 65%
Severe Left ventricular (LV) dysfunction or right ventricular (RV) infarction
Heart rate (HR) ≥ 100 bpm (Sinus Rhythm) in whom beta-blocker therapy cannot be initiated, including: On inotropic or vasopressor support, Requiring an intra-aortic balloon pump (IABP), With Killip class III or IV, Requiring BiPAP or mechanical ventilation

You may not qualify if…

Age > 75 years
CPR > 12 mints
Atrial fibrillation
Complete Heart Block
Heart rate of < 100 bpm
End stage Renal Disease
Extensive comorbidities; Prior CVA, Malignancy, Pregnancy or Ongoing Participation in Other Trials

Where it is running

National institute of cardiovascular diseases — Karachi, Pakistan (enrolling)

Full record on ClinicalTrials.gov

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