{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:54:39Z","timestamp":1787018079852,"version":"build-2736575974"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","funder":[{"name":"Agencja Bada\u0144 Medycznych","award":["2019\/ABM\/01\/00019"],"award-info":[{"award-number":["2019\/ABM\/01\/00019"]}]}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2025,10,21]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Perioperative beta blockade lowers heart rate and decreases the risk of myocardial infarction but increases the risk of hypotension, death, and stroke. Ivabradine, a selective heart rate\u2013lowering agent, may prevent prognostically important myocardial injury after noncardiac surgery (MINS) without causing hemodynamic instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>In this multicenter, double-blind, placebo-controlled trial, we assigned patients \u226545 years of age with, or at risk of, atherosclerotic disease undergoing noncardiac surgery to receive ivabradine (5 mg orally twice daily for up to 7 days, starting 1 hour before surgery) or placebo. The primary outcome was MINS within 30 days from randomization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      All of the 2101 participants who underwent randomization were included in the intention-to-treat population. MINS occurred in 178 of 1050 patients (17.0%) in the ivabradine group and in 159 of 1051 patients (15.1%) in the placebo group (relative risk, 1.12 [95% CI, 0.92 to 1.37];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.25). Enrollment was halted at the prespecified interim analysis because of a conditional power of 6%, below the futility boundary of 20%. The intraoperative mean heart rate was lower in the ivabradine group by 3.2 beats per minute than in the placebo group (95% CI, \u20134.07 to \u20132.36), with no difference in intraoperative mean arterial pressure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Among patients undergoing noncardiac surgery, ivabradine did not reduce the occurrence of MINS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT05279651.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.125.076704","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T15:45:09Z","timestamp":1756568709000},"page":"1126-1135","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Ivabradine in Patients Undergoing Noncardiac Surgery: A Randomized Controlled Trial"],"prefix":"10.1161","volume":"152","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1349-1123","authenticated-orcid":true,"given":"Wojciech","family":"Szczeklik","sequence":"first","affiliation":[{"name":"Centre for Intensive Care and Perioperative Medicine (W.S., J.F., Z.P., A. W\u0142udarczyk, J.G., B.S.), Jagiellonian University Medical College, Krakow, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2110-2992","authenticated-orcid":true,"given":"Jakub","family":"Fronczek","sequence":"additional","affiliation":[{"name":"Centre for Intensive Care and Perioperative Medicine (W.S., J.F., Z.P., A. W\u0142udarczyk, J.G., B.S.), Jagiellonian University Medical College, Krakow, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1740-4322","authenticated-orcid":true,"given":"Zbigniew","family":"Putowski","sequence":"additional","affiliation":[{"name":"Centre for Intensive Care and Perioperative Medicine (W.S., J.F., Z.P., A. W\u0142udarczyk, J.G., B.S.), Jagiellonian University Medical College, Krakow, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1020-6462","authenticated-orcid":true,"given":"Anna","family":"W\u0142udarczyk","sequence":"additional","affiliation":[{"name":"Centre for Intensive Care and Perioperative Medicine (W.S., J.F., Z.P., A. W\u0142udarczyk, J.G., B.S.), Jagiellonian University Medical College, Krakow, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0410-4128","authenticated-orcid":true,"given":"Jacek","family":"G\u00f3rka","sequence":"additional","affiliation":[{"name":"Centre for Intensive Care and Perioperative Medicine (W.S., J.F., Z.P., A. 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