Assessing Catecholamine Treatment Initiation Options: Norepinephrine vs Dopamine for Cardiogenic Shock (ACTION-CS)

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,…

• A composite of 28-day all-cause death or signs of progressive or refractory cardiogenic shock within the first 24 hours

1. Study completion expected

   31 May 2032

2. Primary completion expected

   31 May 2031

3. Last registry update

   15 Oct 2026

4. Started

   16 Jun 2026

5. Registered

   1 May 2026