Key result
Ivabradine significantly reduced resting heart rate and improved LVEF compared to metoprolol in ACS patients, but showed no significant difference in 30-day major cardiac adverse effects.
Why the study?
This study was carried out to analyse and compare the clinical responses of early administration of ivabradine versus metoprolol in patients admitted with acute coronary syndrome with LV systolic dysfunction.
Does early administration of ivabradine improve heart rate, LVEF, and clinical outcomes compared to metoprolol in patients with acute coronary syndrome and LV systolic dysfunction?
RCT
No
Does early administration of ivabradine improve heart rate, LVEF, and clinical outcomes compared to metoprolol in patients with acute coronary syndrome and LV systolic dysfunction?
In patients with ACS and LV systolic dysfunction, early ivabradine administration effectively reduces heart rate and improves LVEF compared to metoprolol, but does not appear to improve short-term clinical outcomes.
May support ivabradine for heart-rate control in ACS; leaves open outcome benefits versus beta-blockers in prospective trials.
BACKGROUND heart rate in ACS is an important pathophysiological variable of mortality it aids progression of atherosclerosis, plaque destabilization and arrhythmias. , beta blockers are the main drug treatment in ACS as it decreases by decreasing heart rate and cardiac arrhythmias. Ivabradine, a selective of funny current channel, reduces resting and exercise induced heart rate thus reduces myocardial oxygen demand without affecting cardiac , conduction, relaxation and repolarization. Now, the indications of has been extended for use alone or in association with beta blockers in of CAD. This present study was carried out to analyse the effect of early of ivabradine versus metoprolol in patients admitted in our hospital acute coronary syndrome with LV systolic dysfunction. The clinical responses evaluated and compared. this study patients were mostly recruited from the critical care department of of R.G. KAR Medical College and Hospital, Kolkata, admitted due to coronary syndrome. After considering inclusion and exclusion criteria, were recruited in the study. Patients were divided into two groups. Group patients received Metoprolol and group B patients received Ivabradine. Baseline follow-up evaluation were done and necessary data were collected and . present study reported significant reduction in heart rate in ivabradine group to other group. However, there was no significant difference in 30 days between both groups. Despite the reduction in heart rate in this study, was no significant improvement in secondary end points compared to other . of ivabradine in patients of ACS showed significant resting heart reduction as well as improved left ventricular ejection fraction though no was seen in major cardiac adverse effects.
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De et al. (2019) conducted an RCT in Acute coronary syndrome with left ventricular systolic dysfunction. Ivabradine vs. Metoprolol was evaluated on 30 days outcome / major cardiac adverse effects. Ivabradine significantly reduced resting heart rate and improved LVEF compared to metoprolol in ACS patients, but showed no significant difference in 30-day major cardiac adverse effects.
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