Safety and efficacy of off-label use of ivabradine in patients with acute heart failure

Ivabradine is approved to improve exercise tolerance and quality of life in patients with chronic heart failure; its use in acute heart failure (AHF) has not previously been studied. Forty adult patients admitted with AHF were randomized into two groups; Group 1 patients were prescribed beta-blocker...

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Bibliographic Details
Published in:	Journal Of The Saudi Heart Association Vol. 31; no. 4; pp. 179 - 187
Main Authors:	Othman, Khaled M. Said, Mostafa, Mohamed Ahmed Radwan, Yosef, Ahmed Elsayed, Abdeltawab, Adham Ahmed
Format:	Journal Article
Language:	English
Published:	Saudi Arabia Elsevier B.V 01-10-2019 Elsevier Saudi Heart Association
Subjects:	Acute heart failure Exercise tolerance Functional capacity Ivabradine Original Exercise tolerance Ivabradine Acute heart failure Functional capacity
Online Access:	Get full text
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Summary:	Ivabradine is approved to improve exercise tolerance and quality of life in patients with chronic heart failure; its use in acute heart failure (AHF) has not previously been studied. Forty adult patients admitted with AHF were randomized into two groups; Group 1 patients were prescribed beta-blockers (BBs) and Group 2 patients were prescribed ivabradine. Both groups were given optimum anti-failure treatment for AHF. All patients were assessed for heart rate (HR), 6-minute walk test (6MWT), New York Heart Association (NYHA) classification, and Minnesota Living With Heart Failure Questionnaire (MLWHFQ) before and after 1 month of therapy. BBs or ivabradine among optimum medical therapy for AHF resulted in a significant improvement in all the studied parameters (NYHA class; 6MWT distance; HR and Borg scale dyspnea/fatigue score before and after the walk). The MLWHFQ was significantly worse during the follow-up in both groups. At the end of follow-up, there was a comparable beneficial effect attributed to the significant HR reduction observed in both groups. The results of this pilot study demonstrated the safety of the early use of ivabradine alone versus BBs when tolerated in patients admitted with AHF (both acutely decompensated as well as de novo). Both groups achieved comparable reduction in HR with improvement in functional capacity and exercise tolerance.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1016-7315 2212-5043
DOI:	10.1016/j.jsha.2019.05.006