Open AccessCOMPARISON STUDY OF IVABRADINE WITH METOPROLOL IN MANAGEMENT OF ACUTE CORONARY SYNDROME
Author(s) -
Rishman Tandi,
Tanvi Kumar,
Amritpal Singh Kahlon,
A. S. Sethi
Publication year - 2021
Publication title -
international journal of medical and biomedical studies
Language(s) - English
Resource type - Journals
eISSN - 2589-8698
pISSN - 2589-868X
DOI - 10.32553/ijmbs.v5i9.2201
Subject(s) - ivabradine , metoprolol , medicine , acute coronary syndrome , bisoprolol , heart rate , cardiology , blood pressure , intensive care unit , coronary care unit , emergency department , anesthesia , emergency medicine , myocardial infarction , psychiatry
Acute coronary syndrome remains as one of the most important causes for morbidity and mortality in developed countries. Therefore, evidence-based management strategy is required to offset the loss of health during an acute coronary syndrome. An effective approach includes both medical and surgical methods. This study was conducted to evaluate the medical method of management.
Objective: To study blood pressure and heart rate variability after administration of Ivabradine or metoprolol in cases with acute coronary syndrome.
Materials and methods: The study was a Prospective single center observational study conducted in patients attending Cardiology Intensive Care Unit in Nayyar Heart and Superspecialty Hospital, a tertiary care centre located in an urban area. All patients with Acute coronary syndrome admitted to the emergency or cardiac care unit were analysed with ECG as a preliminary diagnostic test and confirmed with troponin markers. They were either given Ivabradine or Metoprolol. Baseline evaluation and follow up was done and necessary data was collected and analysed.
Results: 100 patients were included in the study out of which 50 were given Metoprolol (Group A) and 50 were given Ivabradine (Group B). Themean age of studied cases was found to be 66.54 years in group A and 68.69 years in group B. It was observed that there was a fall in heart rate by 26.8 beats per minute with beta blocker and 24.4 beats per minute with Ivabradine. In case of blood pressure measurement, in patients with beta blocker administration, there was a fall of 25 mm Hg in systolic blood pressure and 17 mm Hg in diastolic blood pressure However, with Ivabradine there was only a fall of 8mm Hg in systolic Blood pressure and 6 mm Hg in diastolic blood pressure.
Conclusion: Although Metoprolol is the drug of choice to decrease heart rate and blood pressure in acute coronary syndrome, Ivabradine is being increasingly used in cases where beta blockers are contraindicated as it has similar efficacy in lowering heart rate without compromising contractility of cardiac muscle, thereby maintaining LVEF and blood pressure.
Keywords: Acute coronary syndrome, Beta Blockers, Metoprolol, Ivabradine.