TY - JOUR
T1 - Heart rate control with oral ivabradine in computed tomography coronary angiography
T2 - A randomized comparison of 7.5 mg vs 5 mg regimen
AU - Guaricci, Andrea Igoren
AU - Maffei, Erica
AU - Brunetti, Natale D.
AU - Montrone, Deodata
AU - Di Biase, Luigi
AU - Tedeschi, Carlo
AU - Gentile, Giovanni
AU - Macarini, Luca
AU - Midiri, Massimo
AU - Cademartiri, Filippo
AU - Di Biase, Matteo
PY - 2013/9/20
Y1 - 2013/9/20
N2 - Background: Heart rate (HR) reduction is essential to achieve optimal image quality and diagnostic accuracy with computed tomography coronary angiography (CTCA). Administration of oral ivabradine seems to be more effective than beta-blockade in reducing HR in patients referred for CTCA. Methods: Two-hundred-fifty-nine consecutive patients referred for CTCA were prospectively enrolled. Patients not receiving beta-blocker at baseline (group 1) and those with beta-blocker therapy (group 2) were enrolled in the study. Each group was randomized into 3 parallel arms with 1:1:1 allocation. Patients who did not receive beta-blocker at baseline: underwent CTCA without beta blocker (n = 49), and received ivabradine 5 mg (n = 48), or 7.5 mg ivabradine (n = 48). Patients with beta-blocker therapy: continued with the prior beta-blocker without any dose modification (n = 38), and received ivabradine 5 mg (n = 38), or ivabradine 7.5 mg (n = 38). Results: HR and blood pressure were assessed at admission (T0), immediately before CTCA (T1) and during CTCA (T2). Administration of ivabradine 7.5 mg significantly reduced mean relative HR at T1 and T2 (p < 0.01), the rate of patients not achieving target HR at T1 (p < 0.001) and T2 (p < 0.01), and the percentage of patients needing additional IV beta-blockade prior to CTCA (p < 0.01). Results remained statistically significant even after correction for age, gender, ejection fraction, risk factors and HR at T0, in a multivariable analysis. Conclusions: Ivabradine 7.5 mg is more effective than ivabradine 5 mg in increasing the rate of patients at target HR in patients referred for CTCA.
AB - Background: Heart rate (HR) reduction is essential to achieve optimal image quality and diagnostic accuracy with computed tomography coronary angiography (CTCA). Administration of oral ivabradine seems to be more effective than beta-blockade in reducing HR in patients referred for CTCA. Methods: Two-hundred-fifty-nine consecutive patients referred for CTCA were prospectively enrolled. Patients not receiving beta-blocker at baseline (group 1) and those with beta-blocker therapy (group 2) were enrolled in the study. Each group was randomized into 3 parallel arms with 1:1:1 allocation. Patients who did not receive beta-blocker at baseline: underwent CTCA without beta blocker (n = 49), and received ivabradine 5 mg (n = 48), or 7.5 mg ivabradine (n = 48). Patients with beta-blocker therapy: continued with the prior beta-blocker without any dose modification (n = 38), and received ivabradine 5 mg (n = 38), or ivabradine 7.5 mg (n = 38). Results: HR and blood pressure were assessed at admission (T0), immediately before CTCA (T1) and during CTCA (T2). Administration of ivabradine 7.5 mg significantly reduced mean relative HR at T1 and T2 (p < 0.01), the rate of patients not achieving target HR at T1 (p < 0.001) and T2 (p < 0.01), and the percentage of patients needing additional IV beta-blockade prior to CTCA (p < 0.01). Results remained statistically significant even after correction for age, gender, ejection fraction, risk factors and HR at T0, in a multivariable analysis. Conclusions: Ivabradine 7.5 mg is more effective than ivabradine 5 mg in increasing the rate of patients at target HR in patients referred for CTCA.
KW - Computed tomography coronary angiography
KW - Coronary heart disease
KW - Heart rate reduction
KW - Ivabradine
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U2 - 10.1016/j.ijcard.2012.09.041
DO - 10.1016/j.ijcard.2012.09.041
M3 - Article
C2 - 23063141
AN - SCOPUS:84883763434
SN - 0167-5273
VL - 168
SP - 362
EP - 368
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 1
ER -