Related Experiment Video
Updated: Mar 24, 2026

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration
Published on: April 4, 2022
Antianginal Efficacy of Ivabradine in Patients With History of Coronary Revascularization
J Zarifis1, V Grammatikou2, M Kallistratos3
1Cardiology Department, George Papanikolaou General Hospital, Thessaloniki, Greece.
Insights
Ivabradine effectively reduced angina events and improved quality of life (QOL) in patients with coronary artery disease (CAD) who had undergone coronary revascularization. This treatment offers a valuable option for managing persistent angina post-procedure.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Coronary artery disease (CAD) patients often experience angina even after revascularization.
- Stable angina significantly impacts patient quality of life (QOL).
Purpose of the Study:
- To evaluate the antianginal efficacy of ivabradine.
- To assess the impact of ivabradine on QOL in CAD patients post-revascularization.
Main Methods:
- Post hoc analysis of 926 patients from a prospective, noninterventional study.
- Data collected at baseline, 1 month, and 4 months post-ivabradine initiation.
- Assessed anginal event frequency, nitroglycerin use, and QOL.
Main Results:
- Significant reduction in weekly anginal events (2.2 to 0.3, P < .001).
- Marked decrease in weekly nitroglycerin consumption (1.5 to 0.1, P < .001).
- Significant improvement in QOL compared to baseline (P < .001).
Conclusions:
- Ivabradine, added to beta-blockers, effectively reduces angina in CAD patients post-revascularization.
- Treatment with ivabradine improves QOL in this patient population.
- Ivabradine is a beneficial therapeutic option for managing stable angina after coronary revascularization.
Abstract:
Although coronary revascularization procedures are widely performed in patients with coronary artery disease (CAD), angina is often reported, even after such procedures. This study evaluated the antianginal efficacy and effect of ivabradine treatment on quality of life (QOL) in patients with CAD and history of coronary revascularization. This is a post hoc analysis (926 post-revascularization patients) of a prospective, noninterventional study, which included 2403 patients with CAD and stable angina. The data were recorded at baseline, at 1 month and 4 months after inclusion. After ivabradine administration, mean number of anginal events decreased from 2.2 ± 2.3 (median: 2.0, minimum: 0.0, maximum: 21.0, range: 21.0) to 0.3 ± 0.6 (median: 0.0, minimum: 0.0, maximum: 7.0, range: 7.0) times/week (P < .001), while nitroglycerin consumption decreased from 1.5 ± 2.2 (median: 1.0, minimum: 0.0, maximum: 20.0, range: 20.0) to 0.1 ± 0.4 times/week (median: 0.0, minimum: 0.0, maximum: 5.0, range: 5.0; P < .001). Quality of life improved at study completion compared to baseline (P < .001). Ivabradine addition on top of optimal individualized dose of β-blockers is associated with decreased anginal events and improvement in QOL in patients with stable angina and history of coronary revascularization.
Related Concept Videos
Antianginal Drugs: Calcium Channel Blockers and Ranolazine
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...
Angina IV: Management
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
Coronary Artery Disease V: Interprofessional Care
Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
Antianginal Drugs: Nitrates and β-Blockers
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....

