Evidence map›Paper›PMID 40061514›Full record

Trial reportBJA open2025

Targeted heart rate control using the funny current inhibitor ivabradine to reduce morbidity in patients undergoing noncardiac surgery: study protocol for a phase 2a, triple-blind, placebo-controlled randomised trial.

Bernardo Bollen Pinto, Benjamin Shelley, Priyanthi Dias, Salma Begum, Florence Ennahdi-Elidrissi, Tom E F Abbott, Russell Hewson, Akshaykumar Patel, Kamran Khan, Rupert M Pearse and 2 more

Abstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BJA open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Bernardo Bollen PintoDepartment of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland.
Benjamin ShelleyDepartment of Cardiothoracic Anaesthesia and Intensive Care, Golden Jubilee National Hospital, Clydebank, UK.
Priyanthi DiasFaculty of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, London, UK.
Salma BegumFaculty of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, London, UK.
Florence Ennahdi-ElidrissiDepartment of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland.
Tom E F AbbottFaculty of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, London, UK.
Russell HewsonFaculty of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, London, UK.
Akshaykumar PatelFaculty of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, London, UK.
Kamran KhanFaculty of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, London, UK.
Rupert M PearseFaculty of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, London, UK.
Gareth L AcklandFaculty of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, London, UK.
FUNNY trial investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Myocardial injury is strongly associated with excess morbidity and mortality after noncardiac surgery. Higher heart rate may result in perioperative myocardial injury through demand-supply mismatch. Alternatively, higher heart rates may reflect autonomic dysfunction that promotes myocardial injury independently of heart rate. The specific hyperpolarisation-activated, cyclic nucleotide-gated (HCN)-4 (funny) channel inhibitor ivabradine slows the heart rate without altering autonomic control, blood pressure, or myocardial contractility. We hypothesise that individuals with autonomic dysfunction may benefit most from ivabradine reducing heart rate control to minimise myocardial injury-associated morbidity. Methods: This triple-blind, international, multicentre, randomised, placebo-controlled, parallel group randomised trial will recruit 350 patients, aged ≥55 yr, with cardiovascular risk factors for myocardial injury during elective noncardiac surgery. To achieve the target heart rate <70 beats min Conclusions: This phase 2b study will explore whether targeted heart rate control reduces morbidity after surgery, using ivabradine to selectively slow the heart rate without altering perioperative autonomic control. Clinical trial registration: ISRCTN12903789.

Indexed as

autonomic nervous systemelective surgical procedures/adverse effectsheart ratemyocardial injurypostoperative complicationsprospective studiesvagus nerve

Identifiers

PMID40061514
PMCPMC11889562

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.