Abstract
Introduction: Angina pectoris is the most common manifestation of flow limited coronary stenosis, reflecting myocardial ischemia and limiting significantly ordinary activities of patients. Purpose: To evaluate Ivabradine’s anti-anginal effectiveness and effect on quality of life (QoL), when co-administered with a β-blocker, during a 4 month therapy of patients with coronary artery disease (CAD) and coronary stenosis (>50%) not submitted for revascularization. Methods: This is a post hoc analysis (563 patients with documented coronary stenosis >50%) of a Pan-Hellenic, prospective, non-interventional study including 2403 patients with CAD and stable angina. Follow-up visits were performed at baseline, at 1 and 4 months after inclusion, while patients’ QoL was assessed by EQ-5D questionnaire. Results: 9 patients (1.6%) out of 563 enrolled CAD patients with >50% coronary stenosis, prematurely discontinued treatment. Mean heart rate decrease on study completion compared to baseline was -17.5 bpm (p<0.001), while mean number of angina attacks and nitroglycerin consumption decrease was -1.8 and -1.4 times/week respectively (p<0.001). The percentage of patients with angina CCS I (Canadian Cardiovascular Society classification), increased from 37% (baseline), to 87% (study completion) (p<0.001). For all dimensions of EQ-5D, the improvement was significant leading to an overall amelioration of daily functioning at study completion (p<0.001) At the 1st month of treatment, 52% of patients received 7.5 mg bid of Ivabradine, which was maintained throughout the study, while compliance to treatment was high; almost 97% of the population was taking their treatment “every day” or “quite often” throughout the study. Conclusions: Ivabradine administration presents a significant anti-anginal effect, while improving also QoL and restoring a level of satisfactory usual activity in patients with coronary stenosis >50% not submitted for revascularization.
Published Version
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