Results from a clinical trial show that adding the pure heart rate reduction medication ivabradine on top of current standard treatment for patients with stable angina improves exercise capacity over and above the current standard of care.
The four month randomized double-blind parallel-group study involved almost 900 patients from Canada and internationally with documented coronary artery disease and a history of stable angina. The objective of the study was to determine if treatment with ivabradine could improve exercise capacity in these patients beyond that achieved with their standard treatment. Patients received either ivabradine 5 mg bid for two months (increased to 7.5 mg bid in 87.5% of patients for an additional two months) or placebo for four months in addition to their current beta blocker background therapy (atenolol 50 mg daily).
‘These data confirm that adding ivabradine over and above the standard of care we have available right now achieves a substantial increase in exercise tolerance and is well tolerated,’ said Dr. Jean-Claude Tardif, the study’s lead investigator, director of the Montreal Heart Institute Research Centre and professor of medicine at the Université de Montréal. ‘For patients who have stable angina the results are very encouraging, particularly because of tolerability concerns with higher doses of beta blockers. As a result patients are often not achieving optimal heart rate reduction on standard therapy alone.’
An analysis of the data from treadmill exercise tests shows that patients who were treated with ivabradine in addition to a beta blocker (n=441) demonstrated a threefold improvement in total exercise duration at four months compared to those being treated with standard doses of beta blocker alone. After four months of treatment, the ivabradine and beta blocker combination was associated with a mean heart rate reduction of nine beats per minute (bpm) compared to one bpm in patients remaining on beta blockers alone. Patients receiving the ivabradine and beta blocker combination also had considerable improvements in symptoms and ischemia as measured by time to limiting angina, time to angina onset, and time to 1-mm ST-segment depression.
Release Date: October 30, 2008
Source: University of Montreal