Abstract
This article provides an overview of the therapeutic effects of ivabradine in the treatment of coronary artery disease (CAD), and in the management of stable angina pectoris (SAP) and congestive cardiac failure (CCF). Patients with SAP have a reduced quality of life and are unable to work efficiently, resulting in the increased use of healthcare resources. Unlike the other antianginal drugs (i.e. the beta-blockers, calcium-channel blockers and organic nitrates), ivabradine specifically targets the If current of the sinus node. It reduces the frequency of angina attacks and increases the time until symptoms during work appear. Clinical evidence has shown that ivabradine is an effective anti-ischaemic and antianginal agent, comparable to the beta-blockers and calcium-channel antagonist in controlling the symptoms of myocardial ischemia.
Highlights
Coronary artery disease (CAD) claims the lives of more than seven million people in the world every year, and most of those are in developing countries.[1,2] Optimal medical therapy is actively encouraged and includes using the recommended guidelines as part of management
Strong evidence suggests that heart rate is a marker of risk for cardiovascular disease in the general population, leading to the fact that intervention to reduce elevated heart rate translates into clinical benefit
Some of the groups of drugs used in the treatment of stable angina pectoris, including the β-blockers and some calcium-channel antagonists, remain the first line of treatment for reducing heart rate, their use may be limited by their contraindications and adverse reactions
Summary
Coronary artery disease (CAD) claims the lives of more than seven million people in the world every year, and most of those are in developing countries.[1,2] Optimal medical therapy is actively encouraged and includes using the recommended guidelines as part of management. Angina pectoris is a common symptom of CAD; percutaneous coronary intervention (PCI) is frequently used to relieve the symptoms of angina. The combination of ivabradine and a suitable β-blocker in patients with angina, who had PCI, has proven to be beneficial.[1]. Cardiovascular and all-cause mortality can be associated with resting heart rate, and the mortality benefit of cardiovascular drugs can be linked to their heart rate-lowering effects.[3] The development of a pure heart rate-lowering drug proved to be of great interest in establishing the benefits of heart rate reduction alone. Ivabradine is the first pure heart rate-lowering agent that successfully completed clinical trials for the treatment of stable angina pectoris.[3]
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