Ivabradine: A Review of Labeled and Off-Label Uses

Oliphant, Carrie S.; Owens, Ryan E.; Bolorunduro, Oluwaseyi; Jha, Sunil

doi:10.1007/s40256-016-0178-z

Cited by 29 publications

(21 citation statements)

References 58 publications

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“…While previous research [50] did show improvements in clinical outcome (cardiovascular death or hospital admission for worsening of heart failure) in patients with heart failure after HR reduction with Ivabradine, a recent study in patients with stable coronary disease without clinical heart failure [51], showed that additional treatment with Ivabradine did not lead to a reduction in cardiovascular death or nonfatal myocardial infarctions. Therefore, it is of great interest to further investigate which patient groups may and may not benefit from HR lowering treatment with Ivabradine [52, 53]. In the present study, the animals’ HR was measured once before the MR and US examinations performed after 14 weeks.…”

Section: Discussionmentioning

confidence: 99%

Heart rate lowering treatment leads to a reduction in vulnerable plaque features in atherosclerotic rabbits

et al. 2017

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ObjectiveTo investigate the effect of a heart rate (HR) lowering agent (Ivabradine) on features of atherosclerotic plaque vulnerability with magnetic resonance imaging (MRI), ultrasound imaging, and histology.Approach and resultsAtherosclerosis was induced in the abdominal aorta of 19 rabbits. Nine rabbits were treated with Ivabradine (17 mg/kg/day) during the entire study period. At week 14, imaging was performed. Plaque size was quantified on contrast-enhanced T1-weighted MR images. Microvascular flow, density, and permeability was studied with dynamic contrast-enhanced MRI. Plaque biomechanics was studied by measuring the aortic distension with ultrasound. After, animals were sacrificed and histology was performed.HR was reduced by 16% (p = 0.026) in Ivabradine-treated animals. No differences in absolute and relative vessel wall beat-to-beat distension were found, but due to the reduction in HR, the frequency of the biomechanical load on the plaque was reduced. Plaque size (MR and histology) was similar between groups. Although microvessel density (histology) was similar between groups, AUC and Ktrans, indicative for plaque microvasculature flow, density, and permeability, were decreased by 24% (p = 0.029) and 32% (p = 0.037), respectively. Macrophage content (relative RAM11 positive area) was reduced by 44% (p<0.001) on histology in Ivabradine-treated animals.ConclusionsHR lowering treatment with Ivabradine in an atherosclerotic rabbit model is associated with a reduction in vulnerable plaque features. The current study suggests that HR reduction may be beneficial for inducing or maintaining a more stable plaque phenotype.

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Section: Discussionmentioning

confidence: 99%

Heart rate lowering treatment leads to a reduction in vulnerable plaque features in atherosclerotic rabbits

et al. 2017

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“…Inhibition leads to reduction of the slow depolarization action potential and thereby resulting in decreased heart rate. As far as known, ivabradine does not directly modify other cardiovascular parameters and, therefore, will not cause reduction of blood pressure, in contrast to β-blockers [78,79].…”

Section: Ivabradinementioning

confidence: 97%

New developments in the pharmacotherapeutic management of heart failure in elderly patients: concerns and considerations

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Meijers

Veldhuisen

et al. 2017

Expert Opinion on Pharmacotherapy

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Introduction: Heart failure (HF) remains a major public health problem worldwide, affecting approximately 23 million patients, and is predominantly a disease of the elderly population. Elderly patients mostly suffer from HF with preserved ejection fraction (HFpEF), which often presents with multiple comorbidities and they require multiple medical treatments. This, together with the heterogeneous phenotype of HFpEF, makes it a difficult syndrome to diagnose and treat. Areas covered: Although HF is most abundant in the elderly, this group is still underrepresented in clinical trials, which results in the lack of evidence-based medical regimens. The current review has focused on new potential therapies for this poorly studied population. The focus will be on several classes of drugs currently recommended or might be expected soon. These will include sacubitril/ valsartan (former LCZ696), Omecamtiv mecarbil, Vericiguat, Ivabradine, mineralocorticoid receptor antagonists (MRAs) and potassium binders. Expert opinion: We discuss promising new treatments and hypothesize that personalized approaches will be needed to treat elderly patients optimally. Medical doctors should not only focus on HF therapy, but comorbidities and polypharmacy should also influence therapeutic decision making. Furthermore, the importance of quality of life as a management endpoint should not be underestimated in the frail elderly. ARTICLE HISTORY

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“…A szelektív I f -csatorna-inhibitor gyógyszer, az ivabradin minden esetben hatékony volt. Az alkalmazott adagban, más bradycardizáló gyógyszert együtt nem használva, mellékhatást, intoleranciát nem észleltünk (14)(15)(16)(17). A familiáris IST hátterében számos kiváltó ok már régóta felmerült: a sinuscsomó pacemaker-sejtjeinek fokozott aktivitása/érzékenysége, fokozott szimpatikus szenzitivitás, csökkent vagalis tónus mellett aktiváló-dalom, pszichés feszültség is felmerült.…”

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