Incremental value and safety of oral ivabradine for heart rate reduction in computed tomography coronary angiography

AI Guaricci, JD Schuijf, F. Cademartiri, ND Brunetti, D Montrone, E Maffei, C Tedeschi, R Ieva, L Di Biase, M Midiri, L Macarini, M Di Biase

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Abstract

Background: Heart rate (HR) reduction is essential to achieve optimal image quality and diagnostic accuracy with computed tomography coronary angiography (CTCA). Administration of ivabradine could be an attractive alternative to beta-blockade to reduce HR. Methods: One-hundred-twenty-three patients referred for CTCA were prospectively enrolled. Patients were divided in two groups depending on the absence or presence of chronic beta-blockade treatment. Within the two groups patients were randomized to either no additional premedication or oral ivabradine for 5 days prior to CTCA. In presence of chronic beta-blockade therapy it was shifted to atenolol 50 mg twice a day for 5 days prior to CTCA. HR and blood pressure were assessed at admission (T0), Results: Ivabradine significantly reduced HR during CTCA. Mean relative HR reduction was 15% for controls, 12% for chronic beta-blockade, 19% for ivabradine and 24% for both chronic beta-blockade and ivabradine at T2 (p for trend <0.001). The rate of patients who reached the target HR at T2 was 83% in controls, 71% with chronic beta-blockade, 97% with ivabradine and 97% with both (p for trend <0.05). The percentage of patients that needed additional IV beta-blockade at T1 decreased from 69% to 4 Conclusions: Ivabradine is safe and effective in increasing the rate of patients at target HR and in reducing the need for additional IV beta-blockade in patients referred for CTCA. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
Original languageUndefined/Unknown
Pages (from-to)28-33
Number of pages6
JournalInternational Journal of Cardiology
Volume156
Issue number1
DOIs
Publication statusPublished - 2012

Research programs

  • EMC NIHES-03-30-01

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