Key result
A 7-day premedication protocol with ivabradine increased the proportion of patients achieving a heart rate ≤60 bpm prior to CCTA compared to standard care (48% vs 8%, P<0.01).
Why the study?
Does a 7-day adjusted-dose ivabradine protocol improve heart rate reduction and decrease the need for additional medications in patients undergoing CCTA?
RCT (n=101)
Open-label
Does a 7-day adjusted-dose ivabradine protocol improve heart rate reduction and decrease the need for additional medications in patients undergoing CCTA?
Absolute Event Rate: 48% vs 8%
p-value: p=< 0.01
A 7-day premedication protocol with ivabradine effectively lowers heart rate and reduces the need for intravenous beta-blockers and antianxiety medications in patients undergoing CCTA.
May support ivabradine for pre-CCTA rate control; hypothesis-generating and requires randomized confirmation.
OBJECTIVE: Our prospective, randomized, open-label study assessed the efficacy of a heart rate-lowering, adjusted-dose protocol with ivabradine prior to coronary computed tomographic angiography (CCTA). METHODS: Patients undergoing CCTA were randomized to 7 days of adjusted-dose ivabradine or standard care (ie, no additional medication). Heart rate and β-blocker and antianxiety medication use on the day of the CCTA were recorded. RESULTS: One hundred one patients were randomized (mean age, 60 [SD, 13] years; 66% women). Significantly more patients on ivabradine had heart rates of 60 beats per minute or less at the time of the CCTA scan (48% vs 8%, P < 0.01); accordingly, fewer patients on ivabradine needed additional heart rate lowering with β-blockers (40% vs 86%, P < 0.01), as well as antianxiety medication (18% vs 39%, P < 0.05), and also required lower doses of intravenous β-blockers (4 [SD, 2] vs 7 [SD, 5] mg, P < 0.05). CONCLUSIONS: A 7-day premedication protocol with ivabradine effectively lowers heart rate in patients undergoing CCTA.
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Kacijan et al. (2016) conducted an RCT in Patients undergoing coronary computed tomographic angiography (CCTA) (n=101). Ivabradine vs. Standard care (no additional medication) was evaluated on Heart rate of 60 beats per minute or less at the time of the CCTA scan (p=< 0.01). A 7-day premedication protocol with ivabradine increased the proportion of patients achieving a heart rate ≤60 bpm prior to CCTA compared to standard care (48% vs 8%, P<0.01).
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