title: Effectiveness of Ivabradine Treatment in Different Subpopulations with Stable Angina in Clinical Practice: A Pooled Analysis of Observational Studies.
abstract: OBJECTIVE
  The efficacy of ivabradine has been demonstrated in different subpopulations of stable angina patients in randomized clinical trials. This study explored its effectiveness in subpopulations seen in clinical practice as they often differ from those of randomized trials.
  
  
  METHODS
  Data were pooled from three German observational studies with similar inclusion criteria (stable angina and heart rate ≥60 bpm). All patients received 2.5, 5, or 7.5 mg b.i.d. of ivabradine for 4 months, with or without concomitant beta-blocker. Antianginal effectiveness was analyzed in subpopulations defined by gender, age, heart rate, angina severity, use of concomitant beta-blocker, previous percutaneous coronary intervention procedure, and comorbidities (including previous myocardial infarction and diabetes).
  
  
  RESULTS
  Treatment data were available on 8,555 patients, where therapy with ivabradine was associated with a significant reduction in the frequency of angina attacks and consumption of short-acting nitrates of 87%. Effectiveness was maintained in all investigated subpopulations, with a reduction in antianginal parameters of 82-90%. Clinical status (Canadian Cardiovascular Society class) and quality of life were also improved. Ivabradine was well tolerated in all subgroups.
  
  
  CONCLUSIONS
  Ivabradine is effective and safe in all subpopulations of angina patients seen in clinical practice, independent of age, comorbidities, and use of beta-blocker.
authors.affiliation: Department of Medicine and Heart Centre, University Hospital of the Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Karl
authors.initials: K
authors.lastname: Werdan
authors.forename: Stefan
authors.initials: S
authors.lastname: Perings
authors.forename: Ralf
authors.initials: R
authors.lastname: Köster
authors.forename: Malte
authors.initials: M
authors.lastname: Kelm
authors.forename: Thomas
authors.initials: T
authors.lastname: Meinertz
authors.forename: Georg
authors.initials: G
authors.lastname: Stöckl
authors.forename: Ursula
authors.initials: U
authors.lastname: Müller-Werdan
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D060050:Angina, Stable / Q000145:classification / Q000188:drug therapy*; D001552:Benzazepines / Q000627:therapeutic use*; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate; D006801:Humans; D000077550:Ivabradine; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000008:administration & dosage; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D001552:Benzazepines; D002317:Cardiovascular Agents; D009566:Nitrates; D000077550:Ivabradine