title: Ivabradine in combination with Beta-blockers in patients with chronic stable angina after percutaneous coronary intervention.
abstract: BACKGROUND
  The anti-anginal efficacy of ivabradine is well established. We describe a post hoc analysis in the ADDITIONS database to investigate effectiveness and tolerability of ivabradine in combination with beta-blocker in patients with angina who have had a percutaneous coronary intervention (PCI).
  
  
  METHODS
  ADDITIONS was a non-interventional, multicenter prospective study including 2,330 patients with stable angina. In addition to beta-blocker, patients were treated with ivabradine in approved dosages for 4 months. We divided the population according to whether they had previously had a PCI or not, and explored the effect of ivabradine on heart rate, number of weekly angina attacks, frequency of nitrate consumption, as well as quality of life (QoL) and tolerability.
  
  
  RESULTS
  Data were available for 2,319 patients, of whom 51.4% had previously had a PCI. There was no difference in the effect of ivabradine on mean heart rate between patients with a previous PCI [64.4 ± 7.6 beats per minute (bpm)] than those without (66.8 ± 8.5 bpm) at 4 months (both P < 0.0001). Similarly, the number of angina attacks decreased from 1.9 ± 2.4 to 0.5 ± 1.5 per week in patients with a previous PCI and 1.5 ± 2.0 to 0.3 ± 1.0 per week in patients without a previous PCI (both P < 0.0001). The frequency of nitrate consumption fell from 2.7 ± 3.7 to 1.0 ± 1.9 per week and 1.8 ± 2.8 to 0.6 ± 1.5 per week (both P < 0.0001) in patients with and without a previous PCI, respectively. There was no difference in the improvements in Canadian Cardiovascular Society class of angina, QoL, and physicians' assessment of effectiveness and tolerability between patients with a previous PCI and those without.
  
  
  CONCLUSIONS
  Ivabradine is an effective and well-tolerated anti-anginal treatment in patients with stable angina after PCI. Ivabradine reduced the frequency of weekly angina attacks and nitrate consumption, led to an improvement in Canadian Cardiovascular Society class and a substantial improvement in the QoL of stable angina patients.
authors: Department of Medicine and Heart Centre, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany, karl.werdan@uk-halle.de.
authors: Karl
authors: K
authors: Werdan
authors: Henning
authors: H
authors: Ebelt
authors: Sebastian
authors: S
authors: Nuding
authors: Florian
authors: F
authors: Höpfner
authors: Georg
authors: G
authors: Stöckl
authors: Ursula
authors: U
authors: Müller-Werdan
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D060050:Angina, Stable / Q000188:drug therapy*; D001552:Benzazepines / Q000008:administration & dosage / Q000627:therapeutic use*; D002170:Canada; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D000077550:Ivabradine; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000008:administration & dosage; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life
chemical_list: D000319:Adrenergic beta-Antagonists; D001552:Benzazepines; D002317:Cardiovascular Agents; D009566:Nitrates; D000077550:Ivabradine