Key result
Ivabradine and nebivolol monotherapies demonstrated comparable efficacy in improving left ventricular ejection fraction and reducing heart rate in patients with stable angina pectoris and mild left ventricular dysfunction.
Why the study?
This study aimed to investigate the comparative efficacy of ivabradine and nebivolol monotherapy in treating stable angina pectoris patients with mild left ventricular dysfunction.
Does ivabradine improve heart rate, blood pressure, and left ventricular ejection fraction compared to nebivolol in patients with stable angina pectoris and mild left ventricular dysfunction?
Observational (n=30)
No
Does ivabradine improve heart rate, blood pressure, and left ventricular ejection fraction compared to nebivolol in patients with stable angina pectoris and mild left ventricular dysfunction?
Ivabradine is an effective and well-tolerated alternative to nebivolol for reducing heart rate and chest pain in patients with stable angina and mild LV dysfunction, particularly for those with contraindications to beta-blockers.
May reduce angina faster without BP effects vs nebivolol in mild LV dysfunction SAP; hypothesis-generating, needs RCTs before practice change.
This prospective study aimed to investigate the efficacy of ivabradine and nebivolol in treatment of stable angina pectoris (SAP) patients with mild left ventricular dysfunction. Heart rate decreased (78±6) to (65±5) in Group: A and ( 77± 7) to (70 ± 5) in Group: B. There was no change in Blood pressure reduction in Group:A but significant BP reduction in Nebivolol group. Chest pain was reduced by Ivabradine but in Group : B, chest pain decreased in long term after 6 weeks time. After 6 months’ treatment LVEF for the 15 patients of nebivolol group (50%; Group: A) improved by (48 ± 6.5) to (51 ± 3.2), (p>0.05) and for the 15 patients of Ivabradine group (50%; Group: B) (47 ± 5.4) to (51 ± 2.3), (p>0.05). Ivabradine can be considered as first choice in patient with tachycardia induced angina as this agent for reducing heart rate as well as chest pain. The hypertensive patient with tachycardia may be treated by Nebivolol. Among patients in which effective treatment could not be achieved at maximum nebivolol doses, more effective results were obtained in this study with Ivabradine. University Heart Journal Vol. 15, No. 1, Jan 2019; 8-11
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Hoque et al. (2019) conducted an observational in Stable angina pectoris with mild left ventricular dysfunction (n=30). Ivabradine vs. Nebivolol was evaluated on Left ventricular ejection fraction (LVEF) at 6 months (p=>0.05). Ivabradine and nebivolol monotherapies demonstrated comparable efficacy in improving left ventricular ejection fraction and reducing heart rate in patients with stable angina pectoris and mild left ventricular dysfunction.
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