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

Ralf Köster1, Jan Kaehler, Thomas Meinertz

  • 1University Heart Center Hamburg, Clinic for Cardiology and Angiology, Martinistrasse 52, Hamburg, Germany. rkoester@uke.uni-hamburg.de

American Heart Journal
|September 29, 2009
PubMed

Insights

Ivabradine effectively reduces heart rate and angina symptoms in patients with coronary artery disease. This study confirms its efficacy and safety in real-world clinical practice, mirroring controlled trial results.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Controlled clinical trials on ivabradine's antianginal efficacy have strict patient selection criteria.
  • A discrepancy may exist between controlled trial results and routine clinical practice.
  • This study aimed to evaluate ivabradine's efficacy and safety in everyday practice.

Purpose of the Study:

  • To assess the real-world effectiveness of ivabradine in patients with stable angina pectoris.
  • To evaluate the safety and tolerability of ivabradine in a broad patient population.
  • To compare routine practice outcomes with findings from controlled clinical trials.

Main Methods:

  • A multicenter study involving 4,954 patients with stable angina pectoris.
  • Patients received ivabradine in a routine clinical setting with a 4-month follow-up.
  • Evaluated parameters included heart rate, angina attacks, nitrate consumption, overall efficacy, and tolerance.

Main Results:

  • Ivabradine significantly reduced heart rate (HR) by 12.4 bpm (P < .0001).
  • Weekly angina attacks decreased from 2.4 to 0.4 (P < .0001), and nitrate use reduced significantly (P < .0001).
  • Physicians rated efficacy and tolerance as "excellent/very good" for 97% and 98% of patients, respectively, with low adverse event rates (nausea, dizziness).

Conclusions:

  • Ivabradine is highly effective and well-tolerated for treating symptomatic coronary artery disease in routine practice.
  • The drug significantly reduces heart rate and angina symptoms.
  • Real-world data supports the findings of controlled clinical trials across a diverse patient group.
Abstract

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