Abstract
Objectives
To analyse the effect of the early coadministration of ivabradine and beta-blockers
(intervention group) versus beta-blockers alone (control group) in patients hospitalised
with heart failure and reduced left ventricular ejection fraction (HFrEF).
Methods
A comparative, randomised study was performed to compare the treatment strategies
of beta-blockers alone versus ivabradine and beta-blockers starting 24 hours after hospital admission, for acute HF in patients with an left ventricular
ejection fraction (EF) < 40%, sinus rhythm, and a heart rate (HR) > 70 bpm.
Results
A total of 71 patients were examined, 33 in the intervention group and 38 in the control
group. No differences were observed with respect to their baseline characteristics
or standard treatment at discharge. HR at 28 days (64.3 ± 7.5 vs. 70.3 ± 9.3 bpm, p = 0.01) and at 4 months (60.6 ± 7.5 vs. 67.8 ± 8 bpm, p = 0.004) after discharge were significantly lower in the intervention group. Significant
differences were found with respect to the EF and brain natriuretic peptide levels
at 4 months. No differences in clinical events (rehospitalisation/death) were reported
at 4 months. No severe side effects attributable to the early administration of ivabradine
were observed.
Conclusions
The early coadministration of ivabradine and beta-blockers during hospital admission
for acute HFrEF is feasible and safe, and it produces a significant decrease in HR
at 28 days and at 4 months after hospital discharge. It also seemed to improve systolic function and functional
and clinical parameters of HF patients at short-term.
Keywords
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Article info
Publication history
Published online: April 18, 2016
Accepted:
April 16,
2016
Received:
March 18,
2016
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
