Clinical trial

Efficacy of Carvedilol + Ivabradine vs Carvedilol Alone for Left Ventricular Diastolic Dysfunction in Chronic Liver Disease Patients and Its' Impact on Morbidity and Mortality; a Prospective Randomized Controlled Trial.

Name
INT/IEC/2019/001617
Description
A total of 130 patients with liver cirrhosis who fulfill the criteria of the study, and who have been found to have left ventricular diastolic dysfunction on a screening 2D echocardiography, will then be randomized by Block randomization technique, to two arms in a ratio 1:1(Group A) will receive carvedilol+ Ivabradine targeted therapy for heart rate reduction while Group B will receive Carvedilol alone; and the dosage of drug in the treatment arm will be titrated every week to achieve target heart rate of 50-60/ minute. Patients in the treatment arms, who are unable to tolerate carvedilol due to hypotension episodes, will be offered ivabradine alone to allow achievement of targeted heart rate reduction. All patients will be evaluated at 0,6, and 12 months. The end points will be clinical events, cardiac function improvement, renal function, and mortality.
Trial arms
Trial start
2020-01-01
Estimated PCD
2024-10-01
Trial end
2024-12-01
Status
Recruiting
Treatment
Betablocker + ivabradine
Use of maximum tolerated dose of carvedilol and ivabradine to achieve therapeutic heart rate reduction (THR) to 55-65 beats per minute
Arms:
Carvedilol + Ivabradine
Betablocker
Use of maximum tolerated dose of carvedilol to achieve targeted heart rate reduction (THR) to 55-65 beats per minute (responder) or inability to reach THR (non responder) with maximum dose of carvedilol, maintaining a minimum MAP of 70 mmHg.
Arms:
Carvedilol
Size
130
Primary endpoint
Survival
12 months
Eligibility criteria
Inclusion Criteria: * Age range of 18-65 years * Cirrhosis, as diagnosed by histology or clinical, laboratory and USG findings, * LV diastolic dysfunction on 2D echocardiography Exclusion Criteria: * Chronic renal disease * Patient already on beta blocker * Pregnancy and peripartum cardiomyopathy * Hypertension * Coronary artery disease * Valvular heart disease * Sick sinus syndrome/ Pacemaker * Cardiac rhythm disorder * Hypothyroidism * Hyperthyroidism * Portal vein thrombosis * Transjugular intrahepatic porto systemic shunt (TIPS) insertion * Hepatocellular carcinoma * Anemia Hb \< 8gm/dl in females, and \< 9 gm/dl in males
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['NA'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'PARALLEL', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE', 'maskingDescription': 'Open Label'}}, 'enrollmentInfo': {'count': 130, 'type': 'ESTIMATED'}}
Updated at
2024-02-13

1 organization

2 products

5 indications

Indication
Cirrhosis
Indication
Liver