Antianginal Efficacy of Ivabradine/Metoprolol Combination in Patients With Stable Angina

Zarifis, John; Kallistratos, Manolis S.; Katsivas, Apostolos

doi:10.1002/clc.22585

Cited by 12 publications

(6 citation statements)

References 20 publications

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“…In a different study, 58 59 ivabradine added to metoprolol was shown to improve angina symptoms and QOL in 636 patients with stable angina. Angina attacks were reduced from 2.0/week to 0.2/week (P<0.001) and sublingual nitroglycerin use reduced from 1.4 times/week to 0.1 times/week (P<0.001).…”

Section: Fixed-dose Combined Therapy: New Perspectivesmentioning

confidence: 98%

Role of ivabradine in management of stable angina in patients with different clinical profiles

et al. 2018

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In chronic stable angina, elevated heart rate contributes to the development of symptoms and signs of myocardial ischaemia by increasing myocardial oxygen demand and reducing diastolic perfusion time. Accordingly, heart rate reduction is a well-known strategy for improving both symptoms of myocardial ischaemia and quality of life (QOL). The heart rate-reducing agent ivabradine, a direct and selective inhibitor of the I f current, decreases myocardial oxygen consumption while increasing diastolic time, without affecting myocardial contractility or coronary vasomotor tone. Ivabradine is indicated for treatment of stable angina and chronic heart failure (HF). This review examines available evidence regarding the efficacy and safety of ivabradine in stable angina, when used as monotherapy or in combination with beta-blockers, in particular angina subgroups and in patients with stable angina with left ventricular systolic dysfunction (LVSD) or HF. Trials involving more than 45 000 patients receiving treatment with ivabradine have shown that this agent has antianginal and anti-ischaemic effects, regardless of age, sex, severity of angina, revascularisation status or comorbidities. This heart rate-lowering agent might also improve prognosis, reduce hospitalisation rates and improve QOL in angina patients with chronic HF and LVSD.

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Section: Fixed-dose Combined Therapy: New Perspectivesmentioning

confidence: 98%

Role of ivabradine in management of stable angina in patients with different clinical profiles

et al. 2018

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“…The clinical characteristics, cardiovascular (CV) risk factors, treatment, and outcomes of patients with CAD have changed markedly over the years. Most of the existing data regarding the epidemiology of CAD are relatively old, often focus on 1 manifestation of disease (eg, stable angina) or pertain to acute coronary syndromes, and are often restricted to a single country or a specific geographic region, particularly North America or Western Europe . Thus, there is a need for robust contemporary data in stable CAD representing >1 region and addressing more than symptomatic angina.…”

Section: Introductionmentioning

confidence: 99%

Rationale, design, and baseline characteristics of the CLARIFY registry of outpatients with stable coronary artery disease

Sorbets

Greenlaw

Ferrari

et al. 2017

Clinical Cardiology

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BackgroundDespite major advances in prevention and treatment, coronary artery disease (CAD) remains the leading cause of death worldwide. Whereas many sources of data are available on the epidemiology of acute coronary syndromes, fewer datasets reflect the contemporary management and outcomes of stable CAD patients.HypothesisA worldwide contemporary registry would improve our knowledge about stable CAD. The main objectives are to describe the demographics, clinical profile, contemporary management and outcomes of outpatients with stable CAD; to identify gaps between evidence and treatment; and to investigate long‐term prognostic determinants.Methods CLARIFY (ProspeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease) is an ongoing international observational longitudinal registry. Stable CAD patients from 45 countries in Europe, Asia, America, Middle East, Australia and Africa were enrolled between November 2009 and June 2010. The inclusion criteria were previous myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischemia or prior revascularization procedure. The main exclusion criteria were serious non‐cardiovascular disease, conditions interfering with life expectancy or severe other cardiovascular disease (including advanced heart failure). Follow‐up visits were planned annually for up to 5 years, interspersed with 6‐month telephone calls.ResultsOf the 32,703 patients enrolled, most (77.6%) were male, age (mean ± SD) was 64.2 ± 10.5 years, and 71.0% were receiving treatment for hypertension; mean ± SD resting heart rate was 68.2 ± 10.6 bpm. Patients were enrolled based on a history of myocardial infarction >3 months earlier (57.7%), having at least one stenosis >50% on coronary angiography (61.1%), proven symptomatic myocardial ischemia on non‐invasive testing (23.1%), or history of percutaneous coronary intervention or coronary artery bypass graft (69.8%). Baseline characteristics were similar across the four subgroups identified by the four inclusion criteria.Conclusion CLARIFY will provide a useful resource for understanding the current epidemiology of stable CAD.

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“…Data were recorded at baseline and at 1 month and 4 months after inclusion. Adherence was not a major concern in this study despite free combination 30 …”

Section: Role Of Ivabradine In Different Cardiovascular Diseasesmentioning

confidence: 71%

Ivabradine: Evidence and current role in cardiovascular diseases and other emerging indications

Sathyamurthy

Newale²

2018

Indian Heart Journal

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Increased heart rate (HR) is associated with deleterious effects on several disease conditions. Chronic heart failure (CHF) is one of the cardiovascular diseases with recurrent hospitalization burden and an ongoing drain on health-care expenditure. Despite advancement in medicine, management of CHF remains a challenge to health-care providers. Ivabradine selectively and specifically inhibits the pacemaker I(f) ionic current which reduces the cardiac pacemaker activity. The main effect of ivabradine therapy is the substantial lowering of HR. It does not influence intracardiac conduction, contractility, or ventricular repolarization. As shown in numerous clinical studies, ivabradine improves clinical outcomes and quality of life and reduces the risk of death from heart failure (HF) or other cardiovascular causes. Recently updated HF guidelines recommend ivabradine as a class II indication for reduction of HF hospitalizations. Based on the principle of benefits of reduced HR, the ivabradine in patients with ischemic heart disease, sepsis, and multiple organ dysfunction syndrome has also been studied. It can also be a useful agent for HR reduction in patients with contraindications to use beta-blockers or those who cannot tolerate them. In this review, we provide an overview of efficacy and safety of ivabradine and its combination with currently recommended pharmacological therapy in different conditions.

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Antianginal Efficacy of Ivabradine/Metoprolol Combination in Patients With Stable Angina

Cited by 12 publications

References 20 publications

Role of ivabradine in management of stable angina in patients with different clinical profiles

Role of ivabradine in management of stable angina in patients with different clinical profiles

Rationale, design, and baseline characteristics of the CLARIFY registry of outpatients with stable coronary artery disease

Ivabradine: Evidence and current role in cardiovascular diseases and other emerging indications

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