Heart Rate Control With If Inhibitor, Ivabradine, in Japanese Patients With Chronic Heart Failure　- A Randomized,...

Area of Science:

• Cardiology
• Pharmacology

Background:

• Elevated heart rate (HR) is a significant risk factor for adverse cardiovascular outcomes in heart failure (HF).
• Managing HR is crucial for improving prognosis in HF patients.

Purpose of the Study:

• To evaluate the efficacy and safety of ivabradine, an If inhibitor, in reducing resting HR.
• To assess different starting doses of ivabradine in Japanese symptomatic HF patients.

Main Methods:

• A 6-week, randomized, placebo-controlled study involving 126 Japanese HF patients.
• Patients received placebo, 2.5 mg ivabradine BID, or 5 mg ivabradine BID, with potential dose adjustments.
• Inclusion criteria included LVEF ≤35% and resting HR ≥75 bpm.

Main Results:

• Both 2.5 mg and 5 mg BID doses of ivabradine significantly reduced resting HR compared to placebo (16.6 and 16.4 bpm reduction, respectively).
• The most common side effect was mild phosphenes.
• One patient discontinued treatment due to HF in the 5 mg group.

Conclusions:

• Ivabradine, initiated at 2.5 mg or 5 mg BID, effectively reduces resting HR in Japanese HF patients.
• A starting dose of 2.5 mg BID may be associated with a safer side effect profile.