Purpose: Ischemic heart disease (IHD) is still the main reason for death also in Slovenia. In disease development the heart rate (HR) has an important role. The HR and blood pressure are an indicator of heart burden. It has been proved by trials (ASSOCIATE, BEAUTIFUL, SHIFT) that ivabradin reduces the HR and improves aerobic capacity. We were interested for antiischemic and antianginostic effect of ivabradin, its influence on physical performance, well-being and possible side-effects special in patients (pts) with chronic heart failure (CHF).
Methods: We studied 312 pts (162 woman and 150 men) with IHD. There were 84 pts with CHF. All pts were on beta blockers, ASA and ACE inhibitors. Clinical evaluation, ECG recording, blood pressure measurement, ergospirometry, as well as survey about well-being were performed at the beginning, after 1 month and 3 month. The pts started to take ivabradine 5 mg twice per day. After one month followed an control examination. In pts with HR over 60 we started with ivabradine 7,5 mg twice per day.
Results: The results showed significant reduction of HR from 78 to 59 B/min. The systolic blood pressure reduced from 144 to 132 mm Hg and diastolic from 86 to 78 mm Hg. The angina pectoris attacks decreased from 1,88 to 0,59 attacs per week. Consumption of short acting nitates was reducing from 1,32 to 0,14 pills per week. Physical performance arised from 4,4 to 5,6 METs. 296 pts at the and of study described better well-being. In subgroup with HF we had 49 woman and 35 men. We found out the same reducing of blood pressure, HR, angina pectoris attacks and consumption of short acting nitates. Physical performance arised from 4,8 to 5,3 METs. There were no side effects in both groups.
Conclusions: In this small study we confirm that ivabradin is good antiischemic and antianginostic drug and it significant improves physical performance and quality of life. It is reasonably to combine it with other drugs which we use them for threating IHD and CHF. In pts with IHD, stable angina pectoris, CHF and asthma ivabradine is an decision therapy.