Document Detail

Effects of ivabradine in patients with stable angina receiving beta-blockers according to baseline heart rate: an analysis of the ASSOCIATE study.
MedLine Citation:
PMID:  23138014     Owner:  NLM     Status:  Publisher    
BACKGROUND: Any increase in heart rate (HR) during daily activities above the ischemic threshold may trigger myocardial ischemia. HR reduction with the I(f) inhibitor ivabradine has been demonstrated to confer anti-ischemic and antianginal efficacy in patients with stable angina pectoris. This analysis of the ASSOCIATE trial assessed whether the anti-ischemic efficacy and safety of ivabradine were comparable in patients with baseline resting HRs above and below the median. METHODS: Patients with chronic stable angina pectoris were randomized to treatment with ivabradine (5 to 7.5mg bid) or placebo for 4months, in addition to atenolol 50mg od. The effect of treatment on exercise tolerance test parameters was analyzed in two groups according to baseline HR: >65bpm (n=418) versus ≤65bpm (n=436) (above and below the median, respectively). RESULTS: Ivabradine reduced resting HR in both groups with placebo-corrected reductions of -9.1 (95% CI -11.0 to -7.3; >65bpm group) and -5.9 (95% CI -7.5 to -4.3; ≤65bpm group) (both P<0.001 versus placebo). Ivabradine reduced heart rate at all stages of exercise (all P<0.001). Improvements in exercise capacity (total exercise duration, time to limiting angina, angina onset, and 1-mm ST segment depression, all P<0.05) were recorded in both HR groups. There were no differences between the two groups in terms of safety. CONCLUSIONS: Ivabradine resulted in significant improvements in exercise capacity relative to placebo in patients with stable angina pectoris receiving beta-blocker therapy whether their resting HR was above or below 65bpm.
Jean-Claude Tardif; Piotr Ponikowski; Thomas Kahan;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-5
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Ireland Ltd.
Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada. Electronic address:
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