Document Detail

Relationship between ivabradine treatment and cardiovascular outcomes in patients with stable coronary artery disease and left ventricular systolic dysfunction with limiting angina: a subgroup analysis of the randomized, controlled BEAUTIFUL trial.
MedLine Citation:
PMID:  19720635     Owner:  NLM     Status:  In-Process    
AIMS: BEAUTIFUL found no impact of ivabradine on outcomes in patients with stable coronary artery disease (CAD) and left ventricular systolic dysfunction (LVSD). We performed a post hoc analysis of the effect of ivabradine in BEAUTIFUL patients whose limiting symptom at baseline was angina, particularly in terms of coronary outcomes. METHODS AND RESULTS: Of the BEAUTIFUL population, 13.8% had limiting angina at baseline (734 ivabradine, 773 placebo); of these, 712 patients had heart rate > or =70 b.p.m. Median duration of follow-up was 18 months. Ivabradine was associated with a 24% reduction in the primary endpoint (cardiovascular mortality or hospitalization for fatal and non-fatal myocardial infarction [MI] or heart failure) (HR, 0.76; 95% CI, 0.58-1.00) and a 42% reduction in hospitalization for MI (HR, 0.58, 95% CI, 0.37-0.92). In patients with heart rate > or =70 b.p.m., there was a 73% reduction in hospitalization for MI (HR, 0.27, 95% CI, 0.11-0.66) and a 59% reduction in coronary revascularization (HR, 0.41, 95% CI, 0.17-0.99). Ivabradine was safe and well tolerated. CONCLUSION: Our analyses raises the possibility that ivabradine may be helpful to reduce major cardiovascular events in patients with stable CAD and LVSD who present with limiting angina. However, a large-scale clinical trial is ongoing, which will formally test this hypothesis.
Kim Fox; Ian Ford; Ph Gabriel Steg; Michal Tendera; Michele Robertson; Roberto Ferrari;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-08-31
Journal Detail:
Title:  European heart journal     Volume:  30     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  2337-45     Citation Subset:  IM    
Royal Brompton Hospital, Sydney Street, London, UK.
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Comment In:
Eur Heart J. 2009 Oct;30(19):2300-1   [PMID:  19720636 ]

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