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Role of ivabradine in management of stable angina in patients with different clinical profiles

Kaski, JC; Gloeker, S; Ferrari, R; Fox, K; Lévy, BI; Komajda, M; Vardas, P; Camici, PG (2018) Role of ivabradine in management of stable angina in patients with different clinical profiles. Open Heart, 5. e000725. ISSN 2053-3624 https://doi.org/10.1136/openhrt-2017-000725 (In Press)
SGUL Authors: Kaski, Juan Carlos

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Abstract

In chronic stable angina, elevated heart rate contributes to the development of symptoms and signs of myocardial ischaemia by increasing myocardial oxygen demand and reducing diastolic perfusion time. Accordingly, heart rate reduction is a well-known strategy for improving both symptoms of myocardial ischaemia and quality of life (QOL). The heart rate-reducing agent ivabradine, a direct and selective inhibitor of the I f current, decreases myocardial oxygen consumption while increasing diastolic time, without affecting myocardial contractility or coronary vasomotor tone. Ivabradine is indicated for treatment of stable angina and chronic heart failure (HF). This review examines available evidence regarding the efficacy and safety of ivabradine in stable angina, when used as monotherapy or in combination with beta-blockers, in particular angina subgroups and in patients with stable angina with left ventricular systolic dysfunction (LVSD) or HF. Trials involving more than 45 000 patients receiving treatment with ivabradine have shown that this agent has antianginal and anti-ischaemic effects, regardless of age, sex, severity of angina, revascularisation status or comorbidities. This heart rate-lowering agent might also improve prognosis, reduce hospitalisation rates and improve QOL in angina patients with chronic HF and LVSD.

Item Type: Article
Additional Information: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Open Heart
ISSN: 2053-3624
Dates:
DateEvent
9 March 2018Published
14 February 2018Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
URI: https://openaccess.sgul.ac.uk/id/eprint/109622
Publisher's version: https://doi.org/10.1136/openhrt-2017-000725

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