Key result
Early ivabradine plus metoprolol cuts 1-year MACE ~73% vs metoprolol alone in acute MI post-PCI.
Why the study?
The study was conducted to investigate the efficacy of early ivabradine use in patients with acute myocardial infarction after percutaneous coronary intervention.
Does early use of ivabradine combined with metoprolol improve cardiac function and reduce major adverse cardiac events in patients with acute myocardial infarction after PCI?
RCT (n=80)
Randomized
No
Does early use of ivabradine combined with metoprolol improve cardiac function and reduce major adverse cardiac events in patients with acute myocardial infarction after PCI?
Absolute Event Rate: 10% vs 37.5%
p-value: p=0.004
Early addition of ivabradine to beta-blocker therapy after PCI for acute myocardial infarction significantly improves heart rate control, cardiac function, and exercise tolerance while reducing major adverse cardiac events.
May support early ivabradine addition to beta-blockers post-AMI PCI; extends rate-control evidence in acute settings.
Objective To investigate the efficacy of early use of ivabradine in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods Eighty patients with AMI were randomly divided into the ivabradine group and the control group. The ivabradine group was treated with ivabradine combined with metoprolol after PCI, while the control group was treated with metoprolol only. Both groups were treated continuously for 1 year. Echocardiography-derived parameters, heart rate, cardiopulmonary exercise testing (CPET) data, major adverse cardiac events (MACE) and myocardial markers were analyzed. Results The echocardiography-derived left ventricular ejection fraction was significantly higher in the ivabradine group than in the control group at 1 week, 3 months and 1 year after PCI. The heart rate of the ivabradine group was significantly lower than that of the control group at 1 week after PCI. The VO2max, metabolic equivalents, anaerobic threshold heart rate, peak heart rate, and heart rate recovery at 8 minutes of the ivabradine group were significantly higher than those of the control group at 1 year after PCI. The one-year total incidence of major adverse cardiac events was 10% in the ivabradine group, which was significantly lower than the 37.5% in the control group. The B-type natriuretic peptide of the ivabradine group was significantly lower than that of the control group on Day 2 and Day 3 after PCI. The troponin I level of the ivabradine group was significantly lower than that of the control group on Day 5 after PCI. Conclusion Early use of ivabradine in patients with AMI after PCI can achieve effective heart rate control, reduce myocardial injury, improve cardiac function and exercise tolerance, and reduce the incidence of major adverse cardiac events.
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He et al. (2023) conducted an RCT in Acute myocardial infarction after percutaneous coronary intervention (n=80). Ivabradine combined with metoprolol vs. Metoprolol alone was evaluated on Major adverse cardiac events (MACE) at 1 year (p=0.004). Early use of ivabradine combined with metoprolol significantly reduced the one-year incidence of major adverse cardiac events to 10% compared to 37.5% with metoprolol alone in patients with acute myocardial infarction after PCI.
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