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Ivabradine has a neutral effect on mortality in randomized controlled trials
Sheng Kang1, Chong-Jian Li, Xu-Min Zhang
1Department of Cardiology, Shanghai East Hospital, Tongji University, Shanghai Coronary Heart Disease Center, Cardiovascular Institute and Fuwai Heart Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Medicine
|October 7, 2017
Summary
Ivabradine, a heart rate lowering drug, did not significantly reduce cardiovascular disease or all-cause mortality compared to placebo or beta-blockers in this meta-analysis.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Resting heart rate (RHR) is a debated factor in mortality risk.
- Ivabradine is a selective If current inhibitor that lowers RHR.
- The study investigated ivabradine's efficacy in reducing mortality compared to placebo and beta-blockers.
Purpose of the Study:
- To determine if ivabradine reduces RHR, cardiovascular disease (CVD) mortality, and all-cause mortality.
- To compare the effects of ivabradine versus placebo on mortality.
- To compare the effects of ivabradine versus beta-blockers on mortality.
Main Methods:
- A meta-analysis of 8 randomized controlled trials involving 40,357 participants.
- Included studies compared ivabradine to placebo (36,069 participants) or beta-blockers (4288 participants).
- Analyzed the association between RHR reduction and CVD mortality (2674 deaths) and all-cause mortality (3143 deaths).
Main Results:
- Ivabradine showed no significant reduction in CVD mortality (RR 1.02) or all-cause morbidity (RR 1.00) versus placebo.
- No significant differences in CVD or all-cause morbidity were observed between ivabradine and beta-blockers.
- RHR reduction varied: 8-16 bpm (ivabradine), 1-8 bpm (placebo), 4-24 bpm (beta-blockers).
Conclusions:
- Ivabradine demonstrated a neutral effect on mortality outcomes.
- Pure RHR lowering agents like ivabradine may not reduce CVD or all-cause mortality.
- The drug did not appear to improve lifespan in the studied populations.
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