Key result
Ivabradine reduces heart failure events ~40% vs. placebo or standard care in acute myocardial infarction.
Why the study?
While effective in stable angina and chronic heart failure, the role of ivabradine in acute myocardial infarction remains less clear.
Does ivabradine reduce all-cause mortality, MACE, and heart failure incidence in patients with acute myocardial infarction compared to placebo or standard care?
Meta-Analysis
Does ivabradine reduce all-cause mortality, MACE, and heart failure incidence in patients with acute myocardial infarction compared to placebo or standard care?
Effect estimate: OR 0.60 (95% CI 0.40-0.90)
Ivabradine may reduce cardiovascular complications, particularly heart failure events, in patients post-acute myocardial infarction, especially when combined with beta-blockers.
Supports adding ivabradine to beta-blockers post-AMI to reduce heart failure events; confirms benefit in meta-analysis of randomized data.
INTRODUCTION: While effective in stable angina and chronic heart failure, ivabradine's role in acute myocardial infarction (AMI) is less clear. We assessed the effects of ivabradine versus placebo or standard care on all-cause mortality, major adverse cardiovascular events (MACE) and heart failure in AMI patients. METHODS: We systematically searched six databases through April 2025 for randomized controlled trials (RCTs) comparing ivabradine to control therapy in AMI. Primary outcomes included all-cause mortality, MACE, and heart failure incidence. Random-effects meta-analysis was conducted, with sensitivity analyses using the IVhet model. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and publication bias was explored via funnel plots. RESULTS: = 12%) and heart failure events (OR 0.60, 95% CI: 0.40-0.90). Subgroup analysis indicated greater benefit when combined with beta-blockers. Sensitivity analyses confirmed these findings. CONCLUSION: Ivabradine may reduce cardiovascular complications post-AMI, particularly MACE and heart failure, and may serve as a useful adjunct to standard therapy. Further large-scale trials are warranted. REGISTRATION: This systematic review and meta-analysis was registered on PROSPERO (CRD420251054716).
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Kow et al. (2026) conducted a meta-analysis in Acute myocardial infarction (AMI). Ivabradine vs. Placebo or standard care was evaluated on All-cause mortality, MACE, and heart failure incidence (OR 0.60, 95% CI 0.40-0.90). Ivabradine reduced heart failure events in patients with acute myocardial infarction compared to placebo or standard care (OR 0.60; 95% CI 0.40-0.90).
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