Treatment of stable angina pectoris by ivabradine in every day practice: the REDUCTION study

TY - JOUR

T1 - Treatment of stable angina pectoris by ivabradine in every day practice: the REDUCTION study

AU - Köster, Ralf

AU - Kaehler, Jan

AU - Meinertz, Thomas

AU - REDUCTION Study Group

PY - 2009/10

Y1 - 2009/10

N2 - BACKGROUND: The antianginal efficacy of ivabradine was studied in controlled clinical trials. Strict patient selection criteria may cause a discrepancy between the results of highly controlled clinical trials and everyday routine practice. The objective of this study was to evaluate the efficacy and safety of ivabradine in everyday routine practice.METHODS: In this multicenter study, 4,954 patients with stable angina pectoris received ivabradine in everyday routine practice and underwent follow-up for 4 months. The heart rate (HR), angina pectoris attacks, nitrate consumption, overall efficacy, and tolerance were evaluated.RESULTS: Within 4 months of treatment with ivabradine, HR was reduced by 12.4 +/- 12.2 beat/min from 82.9 +/- 15.3 to 70.4 +/- 9.2 beat/min (P < .0001). Angina pectoris attacks were reduced from 2.4 +/- 3.1 to 0.4 +/- 1.5 per week (P < .0001). Consumption of short-acting nitrates was reduced from 3.3 +/- 4.4 to 0.6 +/- 1.6 U/wk (P < .0001). Seventy-eight cases of adverse drug reactions were reported. The most common adverse drug reactions were nausea (n = 11, 0.22%) and dizziness (n = 9, 0.18%). Efficacy and tolerance were graded by physicians as being "excellent/very good" for 97% and 98% of the patients treated.CONCLUSION: Ivabradine reduces the HR and is highly effective and well tolerated in the treatment of patients with symptomatic coronary artery disease. The results confirm the findings of controlled clinical trials in a broad patient population in everyday routine practice.

AB - BACKGROUND: The antianginal efficacy of ivabradine was studied in controlled clinical trials. Strict patient selection criteria may cause a discrepancy between the results of highly controlled clinical trials and everyday routine practice. The objective of this study was to evaluate the efficacy and safety of ivabradine in everyday routine practice.METHODS: In this multicenter study, 4,954 patients with stable angina pectoris received ivabradine in everyday routine practice and underwent follow-up for 4 months. The heart rate (HR), angina pectoris attacks, nitrate consumption, overall efficacy, and tolerance were evaluated.RESULTS: Within 4 months of treatment with ivabradine, HR was reduced by 12.4 +/- 12.2 beat/min from 82.9 +/- 15.3 to 70.4 +/- 9.2 beat/min (P < .0001). Angina pectoris attacks were reduced from 2.4 +/- 3.1 to 0.4 +/- 1.5 per week (P < .0001). Consumption of short-acting nitrates was reduced from 3.3 +/- 4.4 to 0.6 +/- 1.6 U/wk (P < .0001). Seventy-eight cases of adverse drug reactions were reported. The most common adverse drug reactions were nausea (n = 11, 0.22%) and dizziness (n = 9, 0.18%). Efficacy and tolerance were graded by physicians as being "excellent/very good" for 97% and 98% of the patients treated.CONCLUSION: Ivabradine reduces the HR and is highly effective and well tolerated in the treatment of patients with symptomatic coronary artery disease. The results confirm the findings of controlled clinical trials in a broad patient population in everyday routine practice.

KW - Aged

KW - Angina Pectoris/diagnosis

KW - Benzazepines/administration & dosage

KW - Cyclic Nucleotide-Gated Cation Channels

KW - Dose-Response Relationship, Drug

KW - Electrocardiography

KW - Female

KW - Follow-Up Studies

KW - Germany

KW - Heart Rate/drug effects

KW - Humans

KW - Ivabradine

KW - Male

KW - Prospective Studies

KW - Surveys and Questionnaires

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1016/j.ahj.2009.06.008

DO - 10.1016/j.ahj.2009.06.008

M3 - SCORING: Journal article

C2 - 19781403

VL - 158

SP - 51

EP - 57

JO - AM HEART J

JF - AM HEART J

SN - 0002-8703

IS - 4

ER -