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Eur Heart J. 2009 Mar;30(5):540-8. doi: 10.1093/eurheartj/ehn571. Epub 2009 Jan 9.

Efficacy of the I(f) current inhibitor ivabradine in patients with chronic stable angina receiving beta-blocker therapy: a 4-month, randomized, placebo-controlled trial.

Collaborators (174)

Tardif JC, Tronje JE, Ahuad Guerrero RA, Machado Cesar M, Gotcheva NN, Vejar M, Chaloupka V, Delius W, Edes I, Crea F, Ronnevik PK, Banasiak M, Swed A, Macarie C, Karpov Y, Pella D, Commerford PJ, Kahan T, Alonso Martin JJ, Parshomenko A, Timmis A, Ahuad Guerrero RA, Sokn FJ, Allall OA, Cartasegna LR, del V Lobo Marquez LL, Hirschson Prado A, Hrabar AD, Ibañez JO, Fuselli JJ, Luciardi HL, Macin SM, Rusculleda M, Piombo AC, Sanjurjo MS, Gadaleta FL, Pomposiello JC, Colgue RM, Hominal M, Kuschnir E, Luquez HA, Ronderos R, Amico AC, Machado Cesar LA, Maranhao M, Coelho OR, Manenti E, Herdy AH, Kerr Saraiva JF, Precoma DB, Ribeiro JP, Castro I, de B Silveira JR, Baycheva V, Denchev S, Raev D, Tschirkov A, Dzhurdzhev A, Penev A, Tzekova M, Ma P, Bailey G, Saint-Hilaire R, Desai D, O'Mahony MF, Vejar M, Lanas F, Lamich R, Abadal J, Lucio L, Rubacek M, Jerabek O, Zidkova E, Gorican K, Danczik J, Al Zoebi A, Förster A, Rein W, Nagy A, Katona A, Takacs J, Magel F, Lippai J, Nyuzo B, Kovacs A, Polak G, Nagy J, Sydo T, Papp A, Toth K, Sereg M, Timar S, Tenczer J, Lakatos F, Gaspardone A, Vitale C, Ronnevik P, Istad H, Sirnes PA, Banasiak W, Budaj A, Dluzniewski M, Szwed H, Kawecka-Jaszcz K, Piwowarska W, Achremczyk P, Kwiecien J, Szpajer M, Kopaczewski J, Szymczak K, Kowalisko A, Pluta W, Trojnar R, Drzewiecki A, Macarie C, Vintila MM, Dan AG, Capalneanu R, Ionescu DD, Manitiu I, Popescu M, Aaron G, Karpov YA, Aronov D, Boytsov SA, Gratsiansky NA, Konyakhin AY, Starodubtsev AK, Tereschenko SN, Shevchenko OP, Grishkin YN, Svistov AS, Khasanov N, Naumov V, Zharova EA, Martsevitch S, Kokourina E, Glezer MG, Ivleva AY, Lukjanov Y, Tchurina S, Ermoshkina L, Treshkur T, Usova G, Volkova E, Shaposhnik I, Timofeev A, Chumakova GA, Masin A, Barbarash OL, Yakhontova P, Kolomiets A, Pella D, Dzupina A, Filipova S, Loviska P, Mazur J, Bayat J, de V Basson MM, Mpe M, Naidoo DP, Alonso Martin JJ, Manuel V, Plaza I, Krittayaphong R, Parkhomenko A, Bazilevich A, Goloborodko B, Krayz I, Lyzogub V, Tseluyko V, Vlasenko M, Volkov V, Pell A.

Author information

  • 1Montreal Heart Institute, Université de Montreal, Montreal, Quebec, Canada. jean-claude.tardif@icm-mhi.org

Abstract

AIMS:

To evaluate the anti-anginal and anti-ischaemic efficacy of the selective I(f) current inhibitor ivabradine in patients with chronic stable angina pectoris receiving beta-blocker therapy.

METHODS AND RESULTS:

In this double-blinded trial, 889 patients with stable angina receiving atenolol 50 mg/day were randomized to receive ivabradine 5 mg b.i.d. for 2 months, increased to 7.5 mg b.i.d. for a further 2 months, or placebo. Patients underwent treadmill exercise tests at the trough of drug activity using the standard Bruce protocol for randomization and at 2 and 4 months. Total exercise duration at 4 months increased by 24.3 +/- 65.3 s in the ivabradine group, compared with 7.7 +/- 63.8 s with placebo (P < 0.001). Ivabradine was superior to placebo for all exercise test criteria at 4 months (P < 0.001 for all) and 2 months (P-values between <0.001 and 0.018). Ivabradine in combination with atenolol was well tolerated. Only 1.1% of patients withdrew owing to sinus bradycardia in the ivabradine group.

CONCLUSION:

The combination of ivabradine 7.5 mg b.i.d. and atenolol at the commonly used dosage in clinical practice in patients with chronic stable angina pectoris produced additional efficacy with no untoward effect on safety or tolerability.

Comment in

PMID:
19136486
[PubMed - indexed for MEDLINE]
PMCID:
PMC2649284
Free PMC Article

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