Efficacy of I(f) inhibition with ivabradine in different subpopulations with stable angina pectoris.
OBJECTIVE
The antianginal and anti-ischemic efficacy of ivabradine has been demonstrated in large-scale trials. Pooling trial data allowed for subpopulation analyses of ivabradine's antianginal efficacy.


METHODS
Data on the frequency of angina attacks, short-acting nitrate consumption, and heart rate were pooled from 5 randomized trials in patients with stable angina pectoris receiving 5, 7.5, or 10 mg of ivabradine b.i.d. for 3 or 4 months. The subpopulations were defined according to age, sex, disease characteristics, and comorbidities (severity of angina, history of myocardial infarction, cerebrovascular disease, revascularization status, diabetes, asthma/chronic obstructive pulmonary disease, or peripheral vascular disease).


RESULTS
Efficacy data were available for 2,425 patients (full analysis set), in whom ivabradine reduced the frequency of diary-based angina attacks by 59.4% and nitrate consumption by 53.7%. All subpopulations experienced 51-70% reductions in the frequency of angina attacks, with similar reductions for the other parameters studied. Ivabradine's efficacy was maintained in the presence of different comorbidities. In the safety set, ivabradine reduced heart rate by 14.5%. Ivabradine had a good safety and tolerability profile in all the subpopulations assessed.


CONCLUSIONS
The antianginal efficacy of ivabradine was consistent across all the subpopulations analyzed, independent of the severity of angina and the presence of a comorbidity.
Tendera
Michal
M
3rd Division of Cardiology, Medical University of Silesia, Katowice, Poland. michal.tendera@gcm.pl
Borer
Jeffrey S
JS
Tardif
Jean-Claude
JC
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001552:Benzazepines / Q000008:administration & dosage*; D001026:Coronary Artery Bypass / Q000379:methods; D054815:Cyclic Nucleotide-Gated Cation Channels / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004562:Electrocardiography; D005260:Female; D006801:Humans; D015994:Incidence; D000077550:Ivabradine; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D055502:Secondary Prevention; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome
D001552:Benzazepines; D054815:Cyclic Nucleotide-Gated Cation Channels; D000077550:Ivabradine