Comparative efficacy of ivabradine versus beta-blockers in patients with mitral stenosis in sinus rhythm: systematic review and meta-analysis

Ghadimi, Nashmil; Kaveh, Sara; Shabaninejad, Hosein; Lijassi, Alaadine; Mehr, Ali Zahed; Hosseinifard, Hossein

doi:10.1007/s11096-018-00778-z

Cited by 4 publications

(3 citation statements)

References 29 publications

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“…There is greater evidence supporting its use in patients with mitral stenosis who remain in sinus rhythm. Indeed, several studies have confirmed reduced heart rate and improved symptoms with similar efficacy (and improved tolerance) compared to metoprolol, suggesting a potential role in the setting of beta‐blocker intolerance 70 …”

Section: Mitral Regurgitationmentioning

confidence: 96%

The advantages, pitfalls and limitations of guideline‐directed medical therapy in patients with valvular heart disease

Gill

Chehab

Allen

et al. 2021

European J of Heart Fail

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Heart failure is an inevitable end‐stage consequence of significant valvular heart disease (VHD) that is left untreated and increasingly encountered in an ageing society. Recent advances in transcatheter procedures and improved outcomes after valve surgery mean that intervention can (and should) be considered in all patients – even the elderly and those with multiple comorbidities ‐ at earlier stages of the natural history of primary VHD, before the onset of irreversible left ventricular dysfunction (and frequently before the onset of symptoms). All patients with known VHD should be monitored carefully in the setting of a heart valve clinic and those who meet guideline criteria for surgical or transcatheter intervention referred for intervention without delay. High quality evidence for the use of medical therapy in VHD is limited and achieving target doses in an elderly and comorbid population frequently challenging. Furthermore, determining whether the valve or ventricle is the principal disease driver is crucial (although the distinction is not always binary, and often unclear). Guideline‐directed medical therapy remains the mainstay of treatment for secondary mitral regurgitation ‐ although up to 50% of patients may fail to respond and should be considered for cardiac resynchronization, transcatheter or surgical valve intervention. Early and definitive management strategies are essential and should be overseen by a specialist Heart Team that includes a Heart Failure specialist. In this article, we provide an evidence‐based summary of approaches to the medical treatment of VHD and clinical guidance for the best management of patients in situations where high quality evidence is lacking.

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Section: Mitral Regurgitationmentioning

confidence: 96%

The advantages, pitfalls and limitations of guideline‐directed medical therapy in patients with valvular heart disease

Gill

Chehab

Allen

et al. 2021

European J of Heart Fail

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show abstract

“…Ivabradine did not show a significant difference in maximum exercise HR or exercise duration when compared to β‐blockers in two studies 60,61 . Two meta‐analyses found that ivabradine was inferior to β‐blockers in lowering resting HR but more effective in lowering maximum exercise HR, which translated to improved exercise capacity and duration in one of these reports 65,66 …”

Section: Resultsmentioning

confidence: 98%

Beyond Heart Failure and Ischemic Heart Disease: A Scoping Review of Novel Uses of Ivabradine in Adults

2020

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Ivabradine lowers heart rate by inhibiting the hyperpolarization-activated current in pacemaker cells, and its use for the treatment of heart failure (HF) and ischemic heart disease (IHD) is well described. Ivabradine may be an attractive treatment option for other conditions for which a reduction in heart rate is desirable but less is known about its role in these settings. The primary objective was to perform a scoping review summarizing the literature evaluating novel uses for ivabradine other than HF and IHD in adults. PubMed and EMBASE were searched for articles for all dates through September 2019. Search strategies combined terms generic, commercial/trade, and international names for ivabradine. Manual search of references was also performed to identify additional articles. Studies were included if they were published in English, evaluated the efficacy of ivabradine for indications other than HF or IHD in patients aged 18 years or older, and the primary outcome included clinically relevant end points. Articles were screened first by title and abstract followed by full-text screening of the remaining articles. After removal of duplicates, 1807 records were screened for inclusion and 84 studies were included in this scoping review. Novel uses of ivabradine were reported for various tachyarrhythmias, valvular heart disease, premedication for coronary computed tomography angiography, perioperative risk reduction, sepsis with and without multi-organ dysfunction syndrome, cor pulmonale, reactive airway disease, and erectile dysfunction. This scoping review identified several potential novel uses for ivabradine in adults. This review may help to identify existing gaps where further research is needed to elucidate the role of ivabradine for indications beyond HF and IHD. KEY WORDS ivabradine, tachycardia, asthma, CT angiography, perioperative risk reduction, pulmonary hypertension, multi-organ dysfunction syndrome, valvular heart disease.

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“…Desta forma, o tratamento inicial de escolha é clínico, com controle de frequência cardíaca com betabloqueador, bloqueador de canal de cálcio ou ivabradina (quando em ritmo sinusal e não tolerar medicações anteriores), associado a diurético. 22 Caso haja controle adequado dos sintomas com esta estratégia, o paciente poderá permanecer sem indicação Quadro 2 -Passo 2: Avaliação da etiologia da estenose mitral importante 16,17 Características etiológicas…”

Section: Estenose Mitralunclassified

Atualização das Diretrizes Brasileiras de Valvopatias – 2020

Tarasoutchi¹,

Montera²,

Ramos³

et al. 2020

Arquivos Brasileiros De Cardiologia

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Comparative efficacy of ivabradine versus beta-blockers in patients with mitral stenosis in sinus rhythm: systematic review and meta-analysis

Cited by 4 publications

References 29 publications

The advantages, pitfalls and limitations of guideline‐directed medical therapy in patients with valvular heart disease

The advantages, pitfalls and limitations of guideline‐directed medical therapy in patients with valvular heart disease

Beyond Heart Failure and Ischemic Heart Disease: A Scoping Review of Novel Uses of Ivabradine in Adults

Atualização das Diretrizes Brasileiras de Valvopatias – 2020

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