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Ivabradine

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https://www.readbyqxmd.com/read/27899939/beta-blocker-use-and-risk-of-symptomatic-bradyarrhythmias-a-hospital-based-case-control-study
#1
Hou Tee Lu, Jiyen Kam, Rusli Bin Nordin, Surinder Kaur Khelae, Jing Mein Wang, Chun Ngok Choy, Chuey Yan Lee
OBJECTIVE: To investigate the risk factors of symptomatic bradyarrhythmias in relation to β-blockers use. METHODS: A hospital-based case-control study [228 patients: 108 with symptomatic bradyarrhythmias (cases) and 120 controls] was conducted in Sultanah Aminah Hospital, Malaysia between January 2011 and January 2014. RESULTS: The mean age was 61.1 ± 13.3 years with a majority of men (68.9%). Cases were likely than control to be older, hypertensive, lower body mass index and concomitant use of rate-controlling drugs (such as digoxin, verapamil, diltiazem, ivabradine or amiodarone)...
September 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27895488/advances-in-the-management-of-heart-failure-the-role-of-ivabradine
#2
REVIEW
Ursula Müller-Werdan, Georg Stöckl, Karl Werdan
A high resting heart rate (≥70-75 b.p.m.) is a risk factor for patients with heart failure (HF) with reduced ejection fraction (EF), probably in the sense of accelerated atherosclerosis, with an increased morbidity and mortality. Beta-blockers not only reduce heart rate but also have negative inotropic and blood pressure-lowering effects, and therefore, in many patients, they cannot be given in the recommended dose. Ivabradine specifically inhibits the pacemaker current (funny current, If) of the sinoatrial node cells, resulting in therapeutic heart rate lowering without any negative inotropic and blood pressure-lowering effect...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27880009/antianginal-efficacy-of-ivabradine-metoprolol-combination-in-patients-with-stable-angina
#3
John Zarifis, Manolis Kallistratos, Apostolos Katsivas
Medical treatment is the main clinical strategy for controlling patients with chronic stable angina and improving their quality of life (QoL). Ivabradine treatment on top of metoprolol decreases angina symptoms and improves QoL in patients with stable angina and coronary artery disease (CAD). This is a post hoc analysis (636 CAD patients given ivabradine/metoprolol free combination) of a prospective, noninterventional study that included 2403 patients with CAD and stable angina. Data were recorded at baseline at 1 and 4 months after inclusion...
November 23, 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/27867524/varying-effects-of-recommended-treatments-for-heart-failure-with-reduced-ejection-fraction-meta-analysis-of-randomized-controlled-trials-in-the-esc-and-accf-aha-guidelines
#4
REVIEW
Marius Mark Thomsen, Christian Lewinter, Lars Køber
The aim of this paper is to evaluate the treatment effects of recommended drugs and devices on key clinical outcomes for patients with heart failure with reduced ejection fraction (HFREF). Randomized controlled trials (RCTs) listed in the 2012 HF guideline from the European Society of Cardiology as well as the 2013 HF guideline from the American College of Cardiology Foundation and American Heart Association were evaluated for use in the meta-analysis. RCTs written in English evaluating recommended drugs and devices for the treatment of patients with HFREF were included...
December 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27861199/heart-rate-reduction-with-adjusted-dose-ivabradine-in-patients-undergoing-coronary-computed-tomographic-angiography-a-randomized-trial
#5
Blaž Kacijan, Zala Novak, Borut Jug, Maja Dolenc Novak, Matjaž Vrtovec, Barbara Gužič Salobir
OBJECTIVE: Our prospective, randomized, open-label study assessed the efficacy of a heart rate-lowering, adjusted-dose protocol with ivabradine prior to coronary computed tomographic angiography (CCTA). METHODS: Patients undergoing CCTA were randomized to 7 days of adjusted-dose ivabradine or standard care (ie, no additional medication). Heart rate and β-blocker and antianxiety medication use on the day of the CCTA were recorded. RESULTS: One hundred one patients were randomized (mean age, 60 [SD, 13] years; 66% women)...
November 17, 2016: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/27847478/the-protective-effects-of-ivabradine-in-preventing-progression-from-viral-myocarditis-to-dilated-cardiomyopathy
#6
Li Yue-Chun, Chen Guang-Yi, Ge Li-Sha, Xing Chao, Tian Xinqiao, Lin Cong, Dai Xiao-Ya, Yang Xiangjun
To study the beneficial effects of ivabradine in dilated cardiomyopathy (DCM) mice, which evolved from coxsackievirus B3-induced chronic viral myocarditis. Four-to-five-week-old male balb/c mice were inoculated intraperitoneally with coxsackievirus B3 (Strain Nancy) on days 1, 14, and 28. The day of the first virus inoculation was defined as day 1. Thirty-five days later, the surviving chronic viral myocarditis mice were divided randomly into two groups, a treatment group and an untreated group. Ivabradine was administered by gavage for 30 consecutive days in the treatment group, and the untreated group was administered normal saline...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27846461/ivabradine-as-adjuvant-treatment-for-chronic-heart-failure
#7
Carolina C Mizzaci, Gustavo J M Porfírio, André T Vilela, José Cícero S Guillhen, Rachel Riera
BACKGROUND: Heart failure prevalence is rising throughout the world. Despite current multidrug therapy, heart failure is the cause of frequent hospitalizations and high mortality. OBJECTIVES: To assess the effectiveness and safety of ivabradine in chronic heart failure. METHODS: We searched the databases: the Cochrane Central Register of Controlled Trials CENTRAL (The Cochrane Library), MEDLINE, EMBASE, CINAHL, Conference Proceedings Citation Index - Science and Science Citation Index Expanded on Web of Science and LILACS...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27844147/acute-ivabradine-treatment-reduces-heart-rate-without-increasing-atrial-fibrillation-inducibility-irrespective-of-underlying-vagal-activity-in-dogs
#8
Kazunori Uemura, Masashi Inagaki, Can Zheng, Toru Kawada, Meihua Li, Masafumi Fukumitsu, Masaru Sugimachi
Ivabradine, a bradycardic agent, has been shown to stably reduce patient's heart rate (HR) in the setting of acute cardiac care. However, an association between atrial fibrillation (AF) risk and acute ivabradine treatment remains a controversial clinical issue, and has not been thoroughly investigated. Bradycardia and abnormal atrial refractoriness induced by ivabradine treatment may enhance vulnerability to AF induction, especially when vagal nerve is concurrently activated. We aimed to experimentally investigate the effects of acute ivabradine treatment with/without concurrent vagal activation on AF inducibility...
November 14, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27825166/the-effects-of-ivabradine-on-cardiac-function-after-myocardial-infarction-are-weaker-in-diabetic-rats
#9
Xue Cao, Zhijun Sun, Boya Zhang, Xueqi Li, Hongyuan Xia
BACKGROUND/AIMS: Plasma norepinephrine (NE) and brain natriuretic peptide (BNP, termed BNP-45 in rats) are considered as essential neurohormones indicating heart failure progression. The purposes of this study were to examine the effects of ivabradine (IBD) on cardiac function and plasma NE and BNP-45 after chronic ischemic heart failure (CHF) in non-diabetic rats and diabetic rats. We further determined if sympathetic NE uptake-1 (a major pathway to metabolize NE) mechanism is responsible for the role played by IBD...
2016: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/27822484/impact-of-ivabradine-on-inflammatory-markers-in-chronic-heart-failure
#10
Ilonka Rohm, Daniel Kretzschmar, Rudin Pistulli, Marcus Franz, P Christian Schulze, Christian Stumpf, Atilla Yilmaz
Background. Inflammation plays a crucial role in the progression of chronic heart failure (CHF). Ivabradine is known to reduce the morbidity and mortality of patients with CHF under certain conditions. Beyond the reduction of heart rate, only limited knowledge exists about potential anti-inflammatory effects of ivabradine that might contribute to its benefit in CHF. Thus, the present study aimed to investigate the effect of ivabradine on systemic inflammation. Methods. In the present study, 33 patients with CHF due to dilated, ischemic, and hypertensive cardiomyopathy were treated with ivabradine according to the guidelines of the European Society of Cardiology (ESC)...
2016: Journal of Immunology Research
https://www.readbyqxmd.com/read/27822397/management-of-stable-angina-with-ivabradine-as-safe-alternative-to-patients-with-myasthenia-gravis
#11
Giuliano Ohde Dalledone, Gustavo Lenci Marques, Renata Dal-Prá Ducci, Arnaldo Laffitte Stier Junior, Cláudia Suemi Kamoi Kay, Lineu Cesar Werneck, Paulo José Lorenzoni, Rosana Herminia Scola
Management of cardiac symptoms in myasthenia gravis (MG) patients can be challenging. The aim of this report is to describe the safe use of ivabradine for stable angina in MG patients. A 48 y.o. woman, with MG diagnosis, presented stable angina. Therapies choices were reduced considering concomitant disease as well as previous and unsuccessful cardiologic managements. Ivabradine showed unexpected results. The patient presented an improvement of neurological and cardiac symptoms, bringing ivabradine as one more therapeutic option to similar patients...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27821435/what-can-be-learned-from-recent-new-drug-applications-a-systematic-review-of-drug-interaction-data-for-drugs-approved-by-the-u-s-fda-in-2015
#12
Jingjing Yu, Zhu Zhou, Katie H Owens, Tasha K Ritchie, Isabelle Ragueneau-Majlessi
As a follow-up to previous reviews, the aim of the present analysis was to systematically examine all drug metabolism, transport, PK, and DDI data available in the 33 NDAs and 12 BLAs approved by the FDA in 2015, using the University of Washington Drug Interaction Database©, and to highlight the significant findings. All of the NDAs were well-characterized with regard to drug metabolism, transport, and/or organ impairment, and were fully analyzed in this review. In vitro, a majority of the NMEs were found to be substrates or inhibitors/inducers of at least one DME or transporter...
November 7, 2016: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/27792046/ivabradine-attenuates-the-microcirculatory-derangements-evoked-by-experimental-sepsis
#13
Marcos L Miranda, Michelle M Balarini, Daniela S Balthazar, Lorena S Paes, Maria-Carolina S Santos, Eliete Bouskela
BACKGROUND: Experimental data suggest that ivabradine, an inhibitor of the pacemaker current in sinoatrial node, exerts beneficial effects on endothelial cell function, but it is unclear if this drug could prevent microcirculatory dysfunction in septic subjects, improving tissue perfusion and reducing organ failure. Therefore, this study was designed to characterize the microcirculatory effects of ivabradine on a murine model of abdominal sepsis using intravital videomicroscopy. METHODS: Twenty-eight golden Syrian hamsters were allocated in four groups: sham-operated animals, nontreated septic animals, septic animals treated with saline, and septic animals treated with ivabradine (2...
October 28, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27784216/ivabradine-a-current-overview
#14
Kaushik Guha, Christopher J Allen, Adam Hartley, Rakesh Sharma
Ivabradine, acting on the funny channel in the sino-atrial node, is a promising drug in the treatment of ischaemic heart disease and heart failure. There has been much clinical research conducted exploring its role in these fields. This review discusses the drug development and trial data, and highlights future directions for research.
October 25, 2016: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/27780557/benefits-of-heart-rate-slowing-with-ivabradine-in-patients-with-systolic-heart-failure-and-coronary-artery-disease
#15
REVIEW
Jeffrey S Borer, Prakash C Deedwania, Jae B Kim, Michael Böhm
Heart rate (HR) is a risk factor in patients with chronic systolic heart failure (HF) that, when reduced, provides outcome benefits. It is also a target for angina pectoris prevention and a risk marker in chronic coronary artery disease without HF. HR can be reduced by drugs; however, among those used clinically, only ivabradine reduces HR directly in the sinoatrial nodal cells without other known effects on the cardiovascular system. This review provides current information regarding the safety and efficacy of HR reduction with ivabradine in clinical studies involving >36,000 patients with chronic stable coronary artery disease and >6,500 patients with systolic HF...
December 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27769970/evolving-therapies-for-the-management-of-chronic-and-acute-decompensated-heart-failure
#16
Jennifer C Cook, Richard H Tran, J Herbert Patterson, Jo E Rodgers
PURPOSE: The pharmacology, clinical efficacy, and safety profiles of evolving therapies for the management of chronic heart failure (HF) and acute decompensated heart failure (ADHF) are described. SUMMARY: HF confers a significant financial burden despite the widespread use of traditional guideline-directed medical therapies such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, and aldosterone receptor antagonists, and the rates of HF-related mortality and hospitalization have remained unacceptably high...
November 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27766510/ivabradine-in-patients-with-stable-coronary-artery-disease-a-rationale-for-use-in-addition-to-and-beyond-percutaneous-coronary-intervention
#17
Cosmo Godino, Antonio Colombo, Alberto Margonato
Heart rate is an established prognostic marker for longevity and is an important contributor in the pathophysiology of various cardiovascular diseases, including ischemic heart disease and heart failure. Most ischemic episodes are triggered by an increase in heart rate, which causes an imbalance between myocardial oxygen delivery and consumption. In addition, increased heart rate is a modifiable risk factor for chronic heart failure. Ivabradine, an inhibitor of If ion channels, is an approved second-line anti-ischemic drug for the treatment of angina...
October 21, 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27752846/ivabradine
#18
Michel Komajda
Ivabradine is a blocker of the funny current channels in the sinoatrial node cells. This results in pure heart rate reduction when elevated without direct effect on contractility or on the vessels. It was tested in a large outcome clinical trial in stable chronic heart failure (CHF) with low ejection fraction, in sinus rhythm, on a contemporary background therapy including betablockers (SHIFT: Systolic Heart Failure Treatment with the If inhibitor Trial).The primary composite endpoint (cardiovascular mortality or heart failure hospitalization) was reduced by 18% whereas the first occurrence of heart failure hospitalizations was reduced by 26%...
October 18, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27733074/financial-impact-of-ivabradine-on-reducing-heart-failure-penalties-under-the-hospital-readmission-reduction-program
#19
Anuraag R Kansal, Stanimira Krotneva, Ali Tafazzoli, Harshali K Patel, Jeffrey S Borer, Michael Böhm, Michel Komajda, Juan Maya, Luigi Tavazzi, Ian Ford, Adrian Kielhorn
OBJECTIVE: The introduction of the Hospital Readmission Reduction Program (HRRP) has led to renewed interest in developing strategies to reduce 30-day readmissions among patients with heart failure (HF). In this study, a model was developed to investigate whether the addition of ivabradine to a standard-of-care (SoC) treatment regimen for patients with HF would reduce HRRP penalties incurred by a hypothetical hospital with excess 30-day readmissions. RESEARCH DESIGN: A model using a Monte Carlo simulation framework was developed...
October 13, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27725624/a-treatment-approach-for-patients-with-chronic-systolic-heart-failure
#20
Barry H Greenberg
The treatment of heart failure with reduced ejection (HFrEF) is changing rapidly. Advances over the past several decades have focused on blocking the adverse effects of neurohormonal activation. This approach has resulted in marked improvement in outcomes in the HFrEF population. Despite these advances, however, mortality and morbidity remain high and HFrEF patients have poor quality of life. New approaches to therapy now offer additional benefits. Combined neprilysin inhibition and angiotensin receptor blockade using sacubitril-valsartan (LCZ696) has been shown to be superior to an angiotensin-converting enzyme inhibitor in HFrEF patients...
2016: Reviews in Cardiovascular Medicine
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