Effectiveness and safety of ivabradine in the treatment of acute myocardial infarction: a systematic review and meta-analysis.

Abstract

Cardiovascular diseases have become a prominent threat to public health and quality of life. In recent years, some studies have reported that ivabradine can improve the cardiac function and prognosis of patients with acute myocardial infarction (AMI). We searched China National Knowledge Infrastructure (CNKI), Wanfang database, Chinese Biomedical Literature (CBM), Chongqing Weipu Chinese Sci-tech Journal Database (VIP), PubMed, Cochrane Library, and EMBASE for randomized controlled trials (RCTs) of ivabradine in the treatment of AMI from January 1980 until December 2020. Each RCT was systematically reviewed. A total of 7 RCTs with 658 patients were included. Compared with the control group, the heart rate [mean deviation (MD) =-9.20, 95% confidence interval (CI): -13.03 to -5.38, P<0.00001] and brain natriuretic peptide (BNP) (MD =-112.73, 95% CI: -186.12 to -39.35, P=0.003) of patients who received ivabradine combined with conventional standard treatment were significantly lower and left ventricular ejection fraction (LVEF) (MD =3.17, 95% CI: 2.12 to 4.23, P<0.00001) was significantly better. The difference in adverse events was not statistically significant [odds ratio (OR) =2.45, 95% CI: 0.92 to 6.55, P=0.07]. Ivabradine combined with β-blockers can reduce the resting heart rate and improve heart function in patients with AMI while not increasing adverse events. However, due to limitations in the number and quality of studies included, our conclusions need to be further confirmed by analyzing more studies.