Ivabradine in combination with beta-blocker therapy for the treatment of stable angina pectoris in every day clinical practice.
OBJECTIVE
The anti-anginal efficacy of the selective I(f) inhibitor ivabradine has been demonstrated in controlled clinical trials. However, there is limited information about the safety and efficacy of a combined treatment of ivabradine with beta-blockers, particularly outside of clinical trials in every day practice. This analysis from the REDUCTION study evaluated the safety and efficacy of a combined therapy of beta-blockers and ivabradine in every day practice.


METHODS
In this multi-center study 4,954 patients with stable angina pectoris were treated with ivabradine in every day routine practice and underwent a clinical follow-up for 4 months. 344 of these patients received a co-medication with beta-blockers. Heart rate (HR), angina pectoris episodes, nitrate consumption, overall efficacy and tolerance were analyzed.


RESULTS
After 4 months of treatment with ivabradine HR was reduced by 12.4 ± 11.6 bpm from 84.3 ± 14.6 to 72.0 ± 9.9 bpm, p < 0.0001. Angina pectoris episodes were reduced from 2.8 ± 3.3 to 0.5 ± 1.3 per week, p < 0.0001. Consumption of short-acting nitrates was reduced from 3.7 ± 5.6 to 0.7 ± 1.7 units per week, p < 0.0001. Five patients (1.5%) reported adverse drug reactions (ADR). The most common ADR were nausea and dizziness (<0.6% each). There was no clinically relevant bradycardia. Efficacy and tolerance were graded as 'very good/good' for 96 and 99% of the patients treated.


CONCLUSIONS
Ivabradine effectively reduces heart rate and angina pectoris in combination with beta-blockers and is well tolerated by patients in every day practice.
Koester
Ralf
R
Clinic for General and Interventional Cardiology, University Heart Center Hamburg, Germany. rkoester@uke.uni-hamburg.de
Kaehler
Jan
J
Ebelt
Henning
H
Soeffker
Gerold
G
Werdan
Karl
K
Meinertz
Thomas
T
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy*; D001552:Benzazepines / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000077550:Ivabradine; D008297:Male; D049990:Membrane Transport Modulators / Q000627:therapeutic use*; D008875:Middle Aged; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D001552:Benzazepines; D049990:Membrane Transport Modulators; D000077550:Ivabradine
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