Clinical Efficacy of Ivabradine

Ivabradine is the first selective and specific If inhibitor with a complete clinical development program. This new pharmacological class represents a novel approach to heart rate reduction that could be of special relevance in different clinical situations such as stable angina. Ivabradine was shown to reduce resting heart rate without modifying any major electrophysiological parameters. Thus, exclusive heart rate reduction can be achieved in the clinic as a result of specific and selective If current inhibition. Ivabradine efficacy has been evaluated in a large clinical program in stable angina. This article will present the results of four randomized clinical studies which have evaluated the efficacy of ivabradine in stable angina patients. Ivabradine was shown to be superior to placebo in improving exercise tolerance test (ETT) criteria (n = 360). In a 4-month, double-blind, controlled study (n = 939), ivabradine 5 and 7.5 mg twice daily was shown to be at least as effective as atenolol 50 and 100 mg once daily. Furthermore, the anti-ischemic and antianginal efficacy of ivabradine has been demonstrated versus amlodipine (n = 1,195), improving total exercise duration and other ETT criteria, and reducing the frequency of angina attacks. Additionally, ivabradine maintains its antianginal efficacy in the long term. Ivabradine therefore represents a valuable treatment for patients with stable angina.