Status:

COMPLETED

PeRiOperaTivE CardioproTection With Ivabradine in Non-cardiac Surgery

Lead Sponsor:

University Hospital, Geneva

Conditions:

Myocardial Injury

Myocardial Ischemia

Eligibility:

All Genders

45+ years

Phase:

PHASE4

Brief Summary

Perioperative myocardial injury (PMI) after non-cardiac surgery (NCS), i.e. the elevation of postoperative troponin, occurs in nearly 20% of patients older than 45 years undergoing NCS and is independ...

Eligibility Criteria

Inclusion

  • Informed Consent as documented by signature of patient; AND
  • Undergoing intermediate or high-risk non-cardiac surgery (as defined in European Society of Anaesthesiology guidelines) AND;
  • One of the following:
  • o≥ 75 years old OR; o≥ 45 years old AND at least 1 risk factors independently associated with perioperative myocardial injury (history of coronary artery disease, chronic heart failure, peripheral artery disease, ischemic stroke, hypertension, diabetes mellitus, chronic kidney disease).

Exclusion

  • Inability to provide informed consent;
  • History of hypersensitivity or allergy to ivabradine;
  • Emergency surgery (to be done within 24h of diagnosis);
  • Shock or acute decompensated heart failure at trial inclusion;
  • Low cardiac output syndrome;
  • Arrhythmia:
  • Atrial fibrillation or flutter;
  • AV-block of 3rd degree;
  • Sick sinus syndrome;
  • Sino-atrial block;
  • Pacemaker dependency;
  • Unstable angina;
  • Acute myocardial infarction in the 3 months preceding the trial;
  • Stroke in the 3 months preceding the trial;
  • Cirrhosis Child B and C;
  • Renal failure with a Estimated Glomerular filtration rate ≤ 15 ml/min/1.73m2;
  • Treatment with a strong cytochrome P450 3A4 inhibitors such as azole antifungals (ketoconazole, itraconazole), macrolide antibiotics (clarithromycin, erythromycin; josamycin, telithromycin), HIV protease inhibitors (nelfinavir, ritonavir) and nefazodone;
  • Treatment with verapamil or diltiazem which are moderate CYP3A4 inhibitors and PGP inducers with heart rate reducing properties;
  • Women who are pregnant or breast feeding;
  • Childbearing potential (Of note, woman with history of hysterectomy, surgical sterilization or menopause for longer than 2 years are not considered with childbearing potential, independent of their age);
  • Participation in another study with investigational drug within the 30 days preceding and during the present study;
  • Previous enrolment into the current study.

Key Trial Info

Start Date :

October 5 2020

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

January 11 2022

Estimated Enrollment :

78 Patients enrolled

Trial Details

Trial ID

NCT04436016

Start Date

October 5 2020

End Date

January 11 2022

Last Update

March 2 2022

Active Locations (1)

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1

Geneva University Hospitals

Geneva, Switzerland