Open AccessAntianginal Efficacy of Ivabradine/Metoprolol Combination in Patients With Stable Angina
Author(s) -
Zarifis John,
Kallistratos Manolis,
Katsivas Apostolos
Publication year - 2016
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22585
Subject(s) - medicine , ivabradine , metoprolol , angina , coronary artery disease , cardiology , canadian cardiovascular society , quality of life (healthcare) , heart rate , stable angina , blood pressure , myocardial infarction , nursing
Medical treatment is the main clinical strategy for controlling patients with chronic stable angina and improving their quality of life ( QoL ). Ivabradine treatment on top of metoprolol decreases angina symptoms and improves QoL in patients with stable angina and coronary artery disease ( CAD ). This is a post hoc analysis (636 CAD patients given ivabradine/metoprolol free combination) of a prospective, noninterventional study that included 2403 patients with CAD and stable angina. Data were recorded at baseline at 1 and 4 months after inclusion. Patient QoL was assessed using the EQ‐5D questionnaire. From baseline to study completion; ivabradine administration on top of metoprolol decreased heart rate ( HR ) from 80.8 ± 9.6 to 64.2 ± 6.2 bpm ( P < 0.001). Mean number of angina attacks decreased from 2.0 ± 2.0/wk to 0.2 ± 0.6/wk ( P < 0.001), whereas nitroglycerin consumption decreased from 1.4 ± 1.9 times/wk to 0.1 ± 0.4 times/wk ( P < 0.001). The percentage of patients in Canadian Cardiovascular Society angina class III to IV decreased from 15.4% to 1.9% ( P < 0.001). The improvement of symptoms and angina class led to a significant 14.7‐point increase in EQ‐5D questionnaire score ( P < 0.001). Patients with increased HR showed greater improvement ( P = 0.001). Adherence to treatment during the entire trial was high (98%). Ivabradine combined with metoprolol significantly decreased angina symptoms and use of nitroglycerin in patients with stable angina and CAD , leading to improved QoL . The benefits observed with this combination explain the high rate of adherence to treatment.