Heart rate-reducing agents ivabradine and beta-adrenoblockers in the management of patients with stable effort angina
Abstract
Coronary heart disease (CHD) is the leading lethality cause in internal medicine. Up to 38% of the patients with coronary events die within the first year. Beta-adrenoblocker (BAB) therapy does not always provide adequate heart rate (HR) reduction. To reduce HR more effectively and, therefore, to increase anti-anginal effect, BAB could be combined with an If channel inhibitor (ivabradine). Effectiveness and safety of the ivabradine + BAB combination was studied in patients with effort angina. One clinical case is presented in detail.
About the Authors
Z. M. GaleevaRussian Federation
Kazan
N. A. Andreichev
Russian Federation
Kazan
References
1. Mathers CD, Loncar D. Projections of Global Mortality and Burden of Disease from 2002 to 2030. PLoS Med 2006; 3(11): 442.
2. Steg PhG, Bhatt DL, Wilson PWF, et al. One year cardiovascular event rates in outpatients with atherothrombosis. JAMA 2007; 297: 1197-206.
3. Gillman M, Kannel W, Belanger A, et al. Influence of heart rate on mortality among persons with hypertension: The Framingham study. Am Heart J 1993; 125: 1148-54.
4. Kannel W, Kannel C, Paffenbarger R, Cupples A. Heart rate and cardiovascular mortality: the Framingham Study. Am Heart J 1987; 113: 1489-94.
5. Kjekshus JK. Importance of heart rate in determining betablocker efficacy in acute and long-term myocardial infarction intervention trials. Am J Cardiol 1986; 57: 43F-9.
6. Timolol-induced eduction in mortality and reinfarction in patients surviving acute myocardial infarction / The Norwegian Multicenter Study Group. N Eng J Med 1981; 304: 801-7.
7. Hjalmarson A, Gilpin E, Kjekshus J, et al. Influence of heart rate on mortality after acute myocardial inferction. Am J Сardiol 1990; 65: 547-53.
8. Benetos A, Thomas F, Bean K, et al. Resting heart rate in older people: a predictor of survival to age 85. J Am Geriart Soc 2003; 51: 284-5.
9. ESC Clinical Practice Guidelines. Cardiovascular Disease Prevention — Risk Assessment and Management / Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by representatives of nine societies and by invited experts) [электронный ресурс] / Электрон. дан. — режим доступа: www.escardio.org/guidelines-surveys/esc-guidelines//Pages/cvd-prevention.aspx, свободный. — Загл. с экрана. — Яз. англ.
10. Guidelines on the management of stable angina pectoris: executive summary/The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Heart J 2006; 27 (11): 1341-81.
11. Fox K, Ford I, Steg PG, et al. Heart rate as a prognostic risk factor in patients with coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial. Lancet 2008; 372: 817-21.
12. Colin P, Ghaleh B, Hittinger L, et al. Differential effects of heart rate reduction and beta blockade on left ventricular relaxation during exercise. Am J Physiol Heart Circ Physiol 2002; 282: 672-9.
13. Colin P, Ghaleh B, Monnet X, et al. Contributions of heart rate and contractility to myocardial oxygen balance during exercise. Am J Physiol Heart Circ Physiol 2003; 284: 676-82.
14. Simon L, Ghaleh B, Puybasset L, et al. Coronary and hemodynamic effects of S 16257, a new bradycardic agent, in resting and exercising conscious dogs. J Pharmacol Exp Ther 1995; 275: 659-66.
15. Ерофеева С.Б., Манешина О.А., Белоусов Ю.Б. Место ивабрадина — первого If ингибитора избирательного и специфического действия в лечении сердечно-сосудистых заболеваний. Качеств клин практ 2006; 1: 10-22.
16. Tardif JC, Ford I, Tendera M, et al. Efficacy of ivabradine, a new selective If inhibitor, compared with atenolol in patients with chronic stable angina. Eur Heart J 2005; 26: 2529-36.
17. Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Heart J 2006; 27: 1341-81.
18. Fox K, Ford I, Steg PG, et al. Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebocontrolled trial. The Lancet 372; 9641: 807-16.
19. Kjekshus J Pedersen TR. Reducing the risk of coronary events: evidence from the Scandinavian Simvastatin Survival Study (4S). Am J Cardiol 1995; 76: 64C-8.
20. Effects of an Angiotensin-Converting-Enzyme Inhibitor, Ramipril, on Cardiovascular Events in High-Risk Patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med 2000; 342: 145-53.
Review
For citations:
Galeeva Z.M., Andreichev N.A. Heart rate-reducing agents ivabradine and beta-adrenoblockers in the management of patients with stable effort angina. Cardiovascular Therapy and Prevention. 2011;10(1):59-65. (In Russ.)