| 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. | |
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MedLine Citation:
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PMID: 19720635 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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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. |
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Authors:
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Kim Fox; Ian Ford; Ph Gabriel Steg; Michal Tendera; Michele Robertson; Roberto Ferrari; |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-08-31 |
Journal Detail:
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Title: European heart journal Volume: 30 ISSN: 1522-9645 ISO Abbreviation: Eur. Heart J. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 2337-45 Citation Subset: IM |
Affiliation:
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Royal Brompton Hospital, Sydney Street, London, UK. k.fox@rbht.nhs.uk |
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Comment In:
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Eur Heart J. 2009 Oct;30(19):2300-1
[PMID:
19720636
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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