Ivabradine in Coronary Artery Disease: No Improvement in Outcomes
(HealthDay News) — For patients with stable coronary artery disease without clinical heart failure, ivabradine does not improve outcomes, according to a study published online August 31 in the New England Journal of Medicine. The study was published to coincide with the annual European Society of Cardiology Congress, held from August 30 to September 3 in Barcelona, Spain.
Kim Fox, MD, from Imperial College London, and colleagues examined the effectiveness of ivabradine in 19,102 patients with stable coronary disease without clinical heart failure and a heart rate of ≥70 beats per minute. Participants were randomly allocated to placebo or ivabradine.
The researchers found that the mean heart rate was 60.7 ± 9.0 beats per minute in the ivabradine group and 70.6 ± 10.1 beats per minute in the placebo group at three months. There was no significant between-group difference in the incidence of the primary end point of a composite of death from cardiovascular causes or nonfatal myocardial infarction (6.8% in the ivabradine group vs. 6.4% in the placebo group; hazard ratio, 1.08; 95% confidence interval, 0.96–1.20; P=0.20). There were no between-group differences in the incidences of death from cardiovascular causes and nonfatal myocardial infarction. Among patients with activity-limiting angina, but not among those without activity-limiting angina, ivabradine correlated with increased incidence of the primary end point.
"The addition of ivabradine to standard background therapy to reduce the heart rate did not improve outcomes," the authors write.
The study was funded by Servier, the manufacturer of ivabradine.