Ivabradine: the evidence of its therapeutic impact in angina

Review

(2162) Views  (657) Full article downloads

Authors: Guillaume Marquis-Gravel, Jean-Claude Tardif

Published Date December 2008 Volume 2008:3(1) Pages 0 - 0

DOI: http://dx.doi.org/10.2147/CE.S7439

Guillaume Marquis-Gravel, Jean-Claude Tardif

Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada

Introduction: Stable angina pectoris (SAP) is a widely prevalent disease affecting 30 000 to 40 000 per million people in Europe and the US. SAP is associated with reductions in quality of life and ability to work, and increased use of healthcare resources. Ivabradine is a drug with a unique therapeutic target, the I_f current of the sinus node, developed for the treatment of cardiovascular diseases including SAP. It has an exclusive heart rate reducing effect, without any negative effect on left ventricular function or coronary vasodilatation.

Aims: The aim of this paper is to review the evidence concerning the use of ivabradine in the treatment of SAP.

Evidence review: Ivabradine is an effective antianginal and antiischemic drug, not inferior to the beta blocker atenolol and the calcium channel antagonist (CCA) amlodipine. It decreases the frequency of angina attacks and increases the time to anginal symptoms during exercise. Because of its exclusive chronotropic effect, ivabradine is not associated with the typical adverse reactions associated with beta blockers or other antianginal drugs.

Clinical value: Clinical evidence shows that ivabradine is a very good antiischemic and antianginal agent, being as effective as beta blockade and CCA therapy in controlling myocardial ischemia and symptoms of stable angina. Ongoing studies will determine the potential of ivabradine to improve morbidity and mortality in coronary artery disease and heart failure.

Key words: evidence, I_f current, ivabradine, outcomes, stable angina pectoris, treatment