Key result
Ivabradine links to a ~87% reduction in angina attacks and short-acting nitrate use.
Why the study?
The efficacy of ivabradine has been demonstrated in randomized trials, but its effectiveness in diverse stable angina subpopulations seen in clinical practice was unclear.
Does ivabradine reduce angina attacks and nitrate consumption in patients with stable angina and heart rate ≥60 bpm in routine clinical practice?
Observational (n=8,555)
Yes
Does ivabradine reduce angina attacks and nitrate consumption in patients with stable angina and heart rate ≥60 bpm in routine clinical practice?
In real-world clinical practice, ivabradine effectively reduces angina attacks and nitrate use across various subpopulations of patients with stable angina.
Ivabradine was associated with reduced angina symptoms across real-world subgroups; leaves open confirmation in randomized trials.
OBJECTIVES: The efficacy of ivabradine has been demonstrated in different subpopulations of stable angina patients in randomized clinical trials. This study explored its effectiveness in subpopulations seen in clinical practice as they often differ from those of randomized trials. METHODS: Data were pooled from three German observational studies with similar inclusion criteria (stable angina and heart rate ≥60 bpm). All patients received 2.5, 5, or 7.5 mg b.i.d. of ivabradine for 4 months, with or without concomitant beta-blocker. Antianginal effectiveness was analyzed in subpopulations defined by gender, age, heart rate, angina severity, use of concomitant beta-blocker, previous percutaneous coronary intervention procedure, and comorbidities (including previous myocardial infarction and diabetes). RESULTS: Treatment data were available on 8,555 patients, where therapy with ivabradine was associated with a significant reduction in the frequency of angina attacks and consumption of short-acting nitrates of 87%. Effectiveness was maintained in all investigated subpopulations, with a reduction in antianginal parameters of 82-90%. Clinical status (Canadian Cardiovascular Society class) and quality of life were also improved. Ivabradine was well tolerated in all subgroups. CONCLUSIONS: Ivabradine is effective and safe in all subpopulations of angina patients seen in clinical practice, independent of age, comorbidities, and use of beta-blocker.
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Werdan et al. (2016) conducted an observational in stable angina (n=8,555). Ivabradine was evaluated on frequency of angina attacks and consumption of short-acting nitrates. Ivabradine therapy was associated with an 87% reduction in the frequency of angina attacks and consumption of short-acting nitrates in patients with stable angina.
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