Assessing Catecholamine Treatment Initiation Options: Norepinephrine vs Dopamine for Cardiogenic Shock

The goal of this multicenter, open-label, randomized clinical trial is to learn whether norepinephrine or dopamine is more effective and safer as the first-line vasoactive drug for treating cardiogenic shock in adults. Cardiogenic shock is a life-threatening condition in which the heart cannot pump enough blood to supply the body. The main questions this study aims to answer are: Does norepinephrine reduce the risk of death or worsening cardiogenic shock compared with dopamine? Does norepinephrine lead to fewer complications such as arrhythmias, the need for mechanical circulatory support, or cardiac arrest? Researchers will compare norepinephrine and dopamine to see which drug better stabilizes blood pressure, improves tissue perfusion, and prevents progression of shock during the early phase of treatment. Participants will: Be randomly assigned to receive either norepinephrine or dopamine as the first vasoactive drug Receive treatment and monitoring based on current clinical guidelines for cardiogenic shock Undergo regular assessments of blood pressure, laboratory values, heart rhythm, and organ function during hospitalization Be followed for outcomes at 1 month, 6 months, and 1 year after enrollment This study aims to provide evidence that will help determine which initial vasoactive drug offers better outcomes for patients with cardiogenic shock and guide future treatment recommendations.