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Ivabradine effects in hospitalized acute heart failure patients: a single center retrospective study

Mahmoud Abdelnabi1, Juthipong Benjanuwattra1, Yehia Saleh2

  • 1Internal Medicine Department, Texas Tech University Health Science Center Lubbock, Texas, USA.

American Journal of Cardiovascular Disease
|July 20, 2023
PubMed

Insights

Ivabradine use in acute decompensated heart failure patients did not reduce rehospitalization or mortality. However, it was associated with a lower average heart rate and shorter hospital stay.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Increased heart rate (HR) is detrimental in decompensated heart failure (DHF).
  • Ivabradine is approved for chronic heart failure with reduced ejection fraction (HFrEF).
  • Limited data exists on ivabradine's efficacy and safety in acute decompensated heart failure (ADHF).

Purpose of the Study:

  • To investigate the effects of ivabradine on morbidity and short-term mortality in hospitalized ADHF patients.
  • To evaluate ivabradine's impact on heart rate and length of hospital stay.

Main Methods:

  • Retrospective observational study of 998 ADHF patients on guideline-directed treatment, including beta-blockers.
  • Patients were divided into two groups: beta-blocker alone (No-ivabradine) or beta-blocker plus ivabradine.
  • Propensity matching was used to control for confounding factors; patients with hemodynamic instability were excluded.

Main Results:

  • No significant differences in baseline characteristics, laboratory, or echocardiographic data between groups.
  • Ivabradine group showed significantly lower average HR (87 ± 15 bpm vs. 90 ± 12 bpm) and shorter hospital stay (5.3 ± 2.3 days vs. 7.7 ± 5.6 days).
  • No significant differences in rehospitalization or mortality rates at 1- and 6-month follow-ups.

Conclusions:

  • Ivabradine use in hospitalized ADHF patients was linked to reduced average HR and length of hospital stay.
  • Ivabradine did not demonstrate a benefit in reducing rehospitalization or mortality rates at 1- and 6-month follow-ups.
Abstract

Keywords:
Ivabradineacute heart failurebeta blockerschronic heart failuredecompensated heart failureheart rate control

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