Key result
Ivabradine, a selective If current inhibitor, reduces heart rate and demonstrates anti-ischemic and antianginal efficacy superior to placebo and comparable to beta-blockers.
Why the study?
Does ivabradine reduce heart rate and provide anti-ischemic and antianginal efficacy in patients with coronary artery disease and heart failure?
Does ivabradine reduce heart rate and provide anti-ischemic and antianginal efficacy in patients with coronary artery disease and heart failure?
Ivabradine is a selective If current inhibitor that effectively reduces heart rate and provides anti-ischemic and antianginal benefits without negatively affecting other cardiac parameters.
May support ivabradine in beta-blocker-intolerant CAD/HF patients; leaves open need for confirmatory outcome trials.
Elevated resting heart rate is linked to an increase in both cardiovascular and all-cause mortality, and agents that reduce heart rate have obvious applications in improving the prognosis of coronary artery disease and heart failure. In this short review, we examine the pathophysiological grounds for the original clinical benefits of pure heart rate lowering through the development of a new class of heart-rate-reducing agents. Ivabradine, a novel selective and specific inhibitor of the If pacemaker current in the sinoatrial node cells, is the prototype of this pharmacological class. It has shown anti-ischemic and antianginal efficacy superior to placebo and comparable to β-blockers and calcium channel blockers. In early clinical pharmacological studies, ivabradine was shown to reduce heart rate in a dose-dependent manner without modifying other cardiac parameters such as conduction, contractility, and ventricular repolarization. Ivabradine improves myocardial oxygen delivery and decreases oxygen consumption. Together, these properties make ivabradine a valuable alternative to existing drug therapies for stable angina and other myocardial conditions.
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Benatar et al. (2005) conducted a review in Coronary artery disease and heart failure. Ivabradine vs. Placebo, β-blockers, and calcium channel blockers was evaluated. Ivabradine, a selective If current inhibitor, reduces heart rate and demonstrates anti-ischemic and antianginal efficacy superior to placebo and comparable to beta-blockers.
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