Ivabradine as adjuvant treatment for chronic heart failure.
Int J Cardiol. 2016 Nov 9;227:43-50
Authors: Mizzaci CC, Porfírio GJ, Vilela AT, Guillhen JC, Riera R
Abstract
BACKGROUND: Heart failure prevalence is rising throughout the world. Despite current multidrug therapy, heart failure is the cause of frequent hospitalizations and high mortality.
OBJECTIVES: To assess the effectiveness and safety of ivabradine in chronic heart failure.
METHODS: We searched the databases: the Cochrane Central Register of Controlled Trials CENTRAL (The Cochrane Library), MEDLINE, EMBASE, CINAHL, Conference Proceedings Citation Index - Science and Science Citation Index Expanded on Web of Science and LILACS. Randomized, placebo-controlled studies comparing ivabradine versus placebo, in patients who have symptomatic heart failure. Two authors independently abstracted the data and assessed the eligibility and methodological quality of each trial. Extracted data were analysed by determining the relative risks for dichotomous data, and difference in means for continuous data, of the treated group compared with controls.
RESULTS: Eight randomized controlled trials with an overall number of 17,812 participants were included in this review. After 12months, compared with placebo, ivabradine was not associated with reduction in cardiovascular mortality (RR 0.95, 95% CI 0.88 to 1.02), reduction of all-cause mortality (RR 0.98, 95% CI 0.90 to 1.06) and reduction of hospitalization for heart failure (RR 0.87, 95% CI 0.68 to 1.11). It was not found differences in safety considering cardiac adverse events between ivabradine and placebo (RR 0.96, 95% CI 0.89 to 1.02).
CONCLUSIONS: The available data show that ivabradine did not reduce the risk of death and hospitalization for heart failure compared to placebo. There were no differences in safety considering cardiac adverse events between ivabradine and placebo.
PMID: 27846461 [PubMed - as supplied by publisher]