title: Safety and efficacy of oral ivabradine as a heart rate-reducing agent in patients undergoing CT coronary angiography.
abstract: OBJECTIVE
  To investigate the role of oral ivabradine as a heart rate reducing agent in patients undergoing CT coronary angiography (CTCA). Despite the routine use of β-blockers prior to CTCA studies, it is not uncommon to have patients with heart rates persistently above the target range of 65 bpm. Ivabradine is a selective inhibitor of the I(f) current, which primarily contributes to sinus node pacemaker activity, and has no significant direct cardiovascular effects such as reduction of blood pressure, cardiac contractility or impairment of cardiac conduction.
  
  
  METHODS
  We investigated 100 consecutive patients who had been referred for CTCA for the evaluation of suspected coronary artery disease (CAD). Patients were randomised to receive either of the following two pre-medication protocols: oral metorprolol or oral ivabradine.
  
  
  RESULTS
  Ivabradine was significantly more effective than metorprolol in lowering the heart rate; the mean percentage reduction in heart rate with ivabradine vs metorpolol was 23.89+6.95% vs 15.20+4.50%, respectively (p=0.0001). Metoprolol significantly lowered both systolic and diastolic blood pressure while ivabradine did not. The requirement of additional doses to achieve a target heart rate of <65 beats per min was also significantly more frequent with metoprolol.
  
  
  CONCLUSIONS
  Ivabradine is a potentially attractive alternative to currently used drugs for reduction of heart rate in patients undergoing CTCA.
authors: Department of Cardiology, Sanjay Grandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
authors: K K
authors: KK
authors: Adile
authors: A
authors: A
authors: Kapoor
authors: S K
authors: SK
authors: Jain
authors: A
authors: A
authors: Gupta
authors: S
authors: S
authors: Kumar
authors: S
authors: S
authors: Tewari
authors: N
authors: N
authors: Garg
authors: P K
authors: PK
authors: Goel
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects; D001552:Benzazepines / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D000077550:Ivabradine; D008297:Male; D008790:Metoprolol / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D000959:Antihypertensive Agents; D001552:Benzazepines; D000077550:Ivabradine; D008790:Metoprolol