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Heart rate management using ivabradine in acute myocardial infarction: a propensity score-matched single-center study

Meixian Chen1, Peiqi Zhong1, Chao Li1

  • 1Department of Cardiology, 900th Hospital of PLA Joint Logistic Support Force, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350025, Fujian, China.

Scientific Reports
|November 12, 2025
PubMed

Insights

Ivabradine therapy in acute myocardial infarction (AMI) patients was linked to reduced rehospitalization. This real-world data suggests potential benefits, particularly in specific subgroups, warranting further investigation for heart rate control strategies.

Area of Science:

  • Cardiology
  • Pharmacology
  • Real-world evidence

Background:

  • The clinical utility of ivabradine for heart rate control in acute myocardial infarction (AMI) patients is under ongoing debate.
  • Real-world data is crucial for evaluating the effectiveness and safety of pharmacological interventions in diverse patient populations.

Purpose of the Study:

  • To assess the association between ivabradine treatment and the risk of rehospitalization in patients following an acute myocardial infarction.
  • To identify patient subgroups who may benefit most from ivabradine therapy for heart rate management post-AMI.

Main Methods:

  • Retrospective analysis of real-world data from 408 patients with AMI, with 76 receiving ivabradine.
  • Statistical analyses included Kaplan-Meier, log-rank tests, multivariable Cox regression, and propensity score matching (PSM).
  • Subgroup analyses and interaction tests were performed to explore ivabradine's impact across various risk factors.

Main Results:

  • Before PSM, ivabradine was associated with a reduced risk of all-cause rehospitalization (HR: 0.64).
  • After PSM, this association was not statistically significant (HR: 0.79).
  • Significant reductions in rehospitalization risk were observed in specific subgroups: females, patients with heart rate >70 bpm, Killip class >1, anterior wall MI, >1 diseased vessel, no CKD, and not on clopidogrel.
  • Achieving a target heart rate at discharge was linked to lower rehospitalization (HR: 0.74).
  • Multivariable analysis indicated ivabradine reduced rehospitalization risk over 12 months (aHR: 0.80).

Conclusions:

  • Ivabradine therapy during hospitalization for AMI appears associated with a lower risk of all-cause rehospitalization.
  • The observed benefits were more pronounced in specific patient subgroups, suggesting personalized treatment approaches.
  • Further validation is required to confirm the robustness and clinical implications of these findings.

Keywords:
Acute myocardial infarctionHeart rate controlIvabradinePropensity score matchedReal-world studyRehospitalization

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