Benefits of ivabradine in angina reported in every-day practice

MedWire News: Ivabradine reduces heart rate and is highly effective and well tolerated in the treatment of patients with stable angina, investigators say.

As reported in the American Heart Journal, the results appear to confirm that the benefits of ivabradine seen in clinical trials are experienced by a broad patient population in everyday routine practice.

Ralf Köster (University Heart Center, Hamburg, Germany) and co-workers evaluated the efficacy and safety of ivabradine in everyday routine practice.

A total of 4954 patients were followed by 1503 general practitioners, internal medicine physicians, and cardiologists in private practice in Germany. All had stable angina, received ivabradine in every-day routine practice, and underwent follow-up for 4 months. The heart rate, rate of angina pectoris attacks, nitrate consumption, overall efficacy, and tolerance were evaluated.

The team found that, within 4 months of treatment with ivabradine, heart rate was reduced by 12.5 beats per minute (bpm) from 82.9 to 70.4 bpm, while angina attacks were reduced from 2.4 to 0.4 per week, and consumption of short-acting nitrates was reduced from 3.3 to 0.6 U/wk (all p<0.0001).

There were 78 adverse drug reactions reported, the most common being nausea (n=11, 0.22%) and dizziness (n=9, 0.18%). Efficacy and tolerance were graded by physicians as being excellent for 97% of the patients treated. The authors point out that rates of adverse drug reactions were even lower than have been reported in clinical trials for ivabradine.

Köster and co-workers conclude that the findings show that ivabradine is safe, achieves a significant reduction of heart rate, and is highly efficient for treating angina.

They add: “The patient group included in this study was typical for the broader population with coronary artery disease seen by physicians in day-to-day practice. The high number of patients with concomitant diseases accounting for relative or absolute contraindications to beta blockers demonstrates that there is a broad therapeutic space for ivabradine in every-day practice.”

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