Addition of Ivabradine to Carvedilol Reduces Duration of Carvedilol Uptitration and Improves Exercise Capacity in Patients With Chronic Heart Failure

Bagriy, A. E.; Щукина, Е. В.; Malovichko, SI; Приколота, А. В.

doi:10.1016/s0735-1097(13)60700-7

Cited by 3 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ivabradine can be initiated very early during hospitalization, in the first days, whatever the dosage of ACE inhibitor or beta-blocker. Moreover, in case of beta-blocker initiation, there is evidence that the two can be initiated together [ 24 ] in terms of tolerability and also synergistic effects due to differing modes of action. For example, the increase in stroke volume seen with ivabradine compensates for the decrease in stroke volume seen at beta-blocker initiation and makes possible beta-blocker uptitration faster with a better tolerability, provide heart rate is monitored carefully [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, in case of beta-blocker initiation, there is evidence that the two can be initiated together [ 24 ] in terms of tolerability and also synergistic effects due to differing modes of action. For example, the increase in stroke volume seen with ivabradine compensates for the decrease in stroke volume seen at beta-blocker initiation and makes possible beta-blocker uptitration faster with a better tolerability, provide heart rate is monitored carefully [ 24 ]. Several small-scale off-label trials have explored the possibility of initiating ivabradine in acute HF [ 66 – 70 ].…”

Section: Discussionmentioning

confidence: 99%

“…This suggests a supplementary advantage of combining the two agents: it facilitates up-titration of beta-blocker. There is other preliminary evidence for this ability for patients to support higher doses of beta-blocker when treated concomitantly with ivabradine [ 24 ], in studies in which the beta-blocker up-titration schedule was also shown to be faster with ivabradine than with beta-blocker alone. These effects on beta-blocker up-titration may be related to the compensation of unwanted hemodynamic effects of beta-blocker due to the specific mode of action of ivabradine [ 22 ].…”

Section: Effect Of Ivabradine On Symptoms and Exercise Capacitymentioning

confidence: 99%

See 2 more Smart Citations

Addressing Major Unmet Needs in Patients with Systolic Heart Failure: The Role of Ivabradine

Pereira-Barretto

2016

Am J Cardiovasc Drugs

View full text Add to dashboard Cite

We reviewed clinical evidence for the use of ivabradine in systolic heart failure (HF), in which it appears to improve symptoms, improve quality of life, prevent hospitalization, and prolong survival, thereby addressing unmet needs in the management of HF. Ivabradine provides symptomatic benefits in HF on top of standard therapies, in terms of functional parameters and exercise capacity, and there is some evidence that this leads to improvements in quality of life in symptomatic HF patients, who may have dyspnea, altered exercise capacity, and fatigue. The SHIFT trial demonstrated that ivabradine has significant beneficial effects on major outcomes in HF. Ivabradine had a significant effect on pump failure death, which was reduced by 26 % (p = 0.014), with no effect on sudden cardiac death. This is an important result since pump failure death is currently the main cause of death in HF, and also because the reductions in mortality obtained with beta-blockers and spironolactone in the last 20 years appear to be mainly due to reduction in sudden death rather than reduction in pump failure death. Ivabradine also has a beneficial effect on hospital admissions (−26 %, p < 0.0001), which is clinically relevant since a quarter of HF patients can expect to be readmitted to hospital for HF within 1 month of discharge. Ivabradine-treated patients are also at significantly lower risk of experiencing a second or third hospitalization for worsening HF. Ivabradine clearly has a key role to play in the management of HF by covering the main therapeutic objectives of symptoms, quality of life, and outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Effect Of Ivabradine On Symptoms and Exercise Capacitymentioning

confidence: 99%

See 1 more Smart Citation

Addressing Major Unmet Needs in Patients with Systolic Heart Failure: The Role of Ivabradine

Pereira-Barretto

2016

Am J Cardiovasc Drugs

View full text Add to dashboard Cite

show abstract

“…In another trial, Bagriy et al studied early addition of ivabradine to carvedilol therapy in patients with chronic heart failure. 19 This study included 41 patients with chronic heart failure (NYHA functional class II–III), a history of previous myocardial infarction, and in sinus rhythm with a heart rate ≥70 bpm, who had not taken ivabradine or a beta-blocker for at least 2 months. Patients were randomized to receive carvedilol alone or carvedilol and ivabradine.…”

Section: Ivabradine In the Treatment Of Chronic Heart Failurementioning

confidence: 99%

Risk-benefit assessment of ivabradine in the treatment of chronic heart failure

Urbanek¹,

Kaczmarek²,

Cygankiewicz³

et al. 2014

DHPS

View full text Add to dashboard Cite

Heart rate is not only a major risk marker in heart failure but also a general risk marker. Within the last few years, it has been demonstrated that reduction of resting heart rate to <70 bpm is of significant benefit for patients with heart failure, especially those with impaired left ventricular systolic function. Ivabradine is the first innovative drug synthesized to reduce heart rate. It selectively and specifically inhibits the pacemaker If ionic current, which reduces cardiac pacemaker activity. Therefore, the main effect of ivabradine therapy is a substantial lowering of heart rate. Ivabradine does not influence intracardiac conduction, contractility, or ventricular repolarization. According to the European Society of Cardiology guidelines, ivabradine should be considered in symptomatic patients (New York Heart Association functional class II–IV) with sinus rhythm, left ventricular ejection fraction ≤35%, and heart rate ≥70 bpm despite optimal treatment with a beta-blocker, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, and a mineralocorticoid receptor antagonist. As shown in numerous clinical studies, ivabradine improves clinical outcomes and quality of life and reduces the risk of death from heart failure or cardiovascular causes. Treatment with ivabradine is very well tolerated and safe, even at maximal recommended doses.

show abstract

Efficacy and Safety of Ivabradine in Patients With Severe Chronic Systolic Heart Failure (from the SHIFT Study)

Borer

Böhm

Ford

et al. 2014

The American Journal of Cardiology

View full text Add to dashboard Cite

Addition of Ivabradine to Carvedilol Reduces Duration of Carvedilol Uptitration and Improves Exercise Capacity in Patients With Chronic Heart Failure

Cited by 3 publications

References 0 publications

Addressing Major Unmet Needs in Patients with Systolic Heart Failure: The Role of Ivabradine

Addressing Major Unmet Needs in Patients with Systolic Heart Failure: The Role of Ivabradine

Risk-benefit assessment of ivabradine in the treatment of chronic heart failure

Efficacy and Safety of Ivabradine in Patients With Severe Chronic Systolic Heart Failure (from the SHIFT Study)

Contact Info

Product

Resources

About