Abstract

Introduction: Coronary revascularization procedures are widely performed for the symptomatic treatment of patients with coronary artery disease (CAD). Even after such procedures, angina symptoms often remain. Hypothesis: To evaluate the antianginal effectiveness and the effect on quality of life of ivabradine co-administered with a β-blocker, during 4-month therapy of CAD patients with a history of coronary revascularization. Methods: This is a post hoc analysis (926 post-revascularization patients) of a Pan-Hellenic, prospective, non interventional study including 2403 patients with CAD and stable angina. Data were recorded at baseline, and at 1 and 4 months after inclusion, while patients’ quality of life was assessed by means of the EQ-5D questionnaire. Results: Of 926 CAD patients who participated in the study, 28 (3%) prematurely discontinued treatment. Addition of ivabradine decreased mean heart rate from 80.3±9.5 bpm (1st visit) to 67.8±7.3 bpm (2nd visit) and 63.9±6.2 bpm (3rd visit) (P<0.001). Mean number of angina attacks and nitroglycerin consumption decreased, respectively, from 2.2±2.3/1.5±2.2 times/week (1st visit) to 0.5±1.0/0.3±0.8 (2nd visit) and 0.3±0.6/0.1±0.4 times times/week (3rd visit) (P<0.001). Moreover, the percentage of patients with angina CCS I (Canadian Cardiovascular Society classification) increased from 36% at baseline to 83% at study completion (P<0.001), while those with angina CCS III-IV decreased from 21% to 2% (P<0.001). All dimensions of the EQ-5D questionnaire were significantly improved after 4 months of treatment with ivabradine (P<0.001) (Table 1). Compliance with ivabradine treatment was high. Throughout the trial, 884 patients (95.5%) were taking their treatment “every day” or “quite often.” Conclusions: These results confirm the antianginal effectiveness as well as the beneficial effect of ivabradine on the quality of life of patients with CAD and a history of coronary revascularization.

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