Related Experiment Video

Updated: Jun 10, 2026

The Intra-Aortic Balloon Pump
06:13

The Intra-Aortic Balloon Pump

Published on: February 5, 2021

Ivabradine: the evidence of its therapeutic impact in angina

Guillaume Marquis-Gravel1, Jean-Claude Tardif

  • 1Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.

Core Evidence
|August 10, 2010
PubMed

Insights

Ivabradine effectively treats stable angina pectoris (SAP) by reducing heart rate without negatively impacting heart function. This antianginal drug offers an alternative to traditional therapies like beta blockers.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Stable angina pectoris (SAP) is a prevalent cardiovascular disease impacting quality of life and healthcare resources.
  • Ivabradine targets the sinus node I(f) current for heart rate reduction in cardiovascular diseases.

Purpose of the Study:

  • To review evidence on ivabradine's efficacy and safety in treating stable angina pectoris.

Main Methods:

  • Review of clinical evidence comparing ivabradine to beta blockers (atenolol) and calcium channel antagonists (amlodipine).
  • Assessment of ivabradine's antianginal and antiischemic effects, including impact on angina frequency and exercise tolerance.

Main Results:

  • Ivabradine demonstrates comparable efficacy to atenolol and amlodipine in managing SAP.
  • It effectively reduces angina attacks and prolongs time to symptom onset during exercise.
  • Its selective heart rate-lowering effect avoids adverse reactions associated with other antianginal drugs.

Conclusions:

  • Ivabradine is a valuable antianginal and antiischemic agent for SAP, matching the effectiveness of beta-blockade and CCA therapy.
  • Further research is ongoing to evaluate its potential impact on morbidity and mortality in coronary artery disease and heart failure.
Abstract

Keywords:
If currentevidenceivabradineoutcomesstable angina pectoristreatment

Related Concept Videos

Antianginal Drugs: Calcium Channel Blockers and Ranolazine01:25

Antianginal Drugs: Calcium Channel Blockers and Ranolazine

Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
Adrenergic Antagonists: ɑ and β-Receptor Blockers01:31

Adrenergic Antagonists: ɑ and β-Receptor Blockers

Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is clinically...
Antianginal Drugs: Nitrates and β-Blockers01:16

Antianginal Drugs: Nitrates and β-Blockers

In cardiovascular health, antianginal drugs combat angina pectoris — a condition marked by chest pain owing to diminished blood flow to the heart.
Organic nitrates,  such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow. Administered...
Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers01:20

Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers

Class IV antiarrhythmic drugs, such as verapamil and diltiazem, block calcium channels. They primarily affect the heart, slowing the conduction in calcium-dependent tissues like the SA and AV nodes. These drugs manage reentrant supraventricular tachycardia (SVT) and reduce ventricular rate in atrial flutter/fibrillation.
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
Angina IV: Management01:26

Angina IV: Management

IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which indirectly block calcium...