Ivabradine in the Acute Management of Cardiogenic Shock

Brief Summary:The IVASHOCK trial investigates whether ivabradine can achieve at least one‐classimprovement in SCAI cardiogenic shock classification compared to placebo, and evaluatesits safety profile in patients with cardiogenic shock (CS).Primary Objectives: 1. To determine whether ivabradine improves SCAI shock classification by at least oneclass from baseline within 72 hours compared to placebo 2. To assess whether ivabradine facilitates earlier weaning from vasoactive andinotropic support compared to placeboSafety Endpoints:Adverse events monitored include: sinus node dysfunction, new‐onset atrial fibrillationor atrial flutter, atrioventricular block, drug‐related hypotension, and ventriculararrhythmia.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 hourson 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