Incremental value and safety of oral ivabradine for heart rate reduction in computed tomography coronary angiography

被引：42

作者：

Guaricci, Andrea I. ^{[1
]}

Schuijf, Joanne D. ^{[2
]}

Cademartiri, Filippo ^{[3
,4
]}

Brunetti, Natale Daniele ^{[1
]}

Montrone, Deodata ^{[1
]}

Maffei, Erica ^{[3
]}

Tedeschi, Carlo ^{[1
]}

Ieva, Riccardo ^{[1
]}

Di Biase, Luigi ^{[1
]}

Midiri, Massimo ^{[6
]}

Macarini, Luca ^{[5
]}

Di Biase, Matteo ^{[1
]}

机构：

[1] Univ Foggia, Dept Cardiol, I-71100 Foggia, Italy

[2] Leiden Univ, Med Ctr, Leiden, Netherlands

[3] Azienda Osped Univ, Dept Radiol & Cardiol, Parma, Italy

[4] Erasmus MC, Dept Radiol & Cardiol, Rotterdam, Netherlands

[5] Univ Foggia, Dept Radiol, I-71100 Foggia, Italy

[6] Univ Hosp P Giaccone, Dept Radiol, DIBIMEL, Palermo, Italy

来源：

INTERNATIONAL JOURNAL OF CARDIOLOGY | 2012年 / 156卷 / 01期

关键词：

Ivabradine; Heart rate reduction; Computed tomography coronary angiography; Coronary heart disease; DIAGNOSTIC-ACCURACY; IMAGE QUALITY; MULTIDETECTOR CT; ARTERY STENOSES; STABLE ANGINA; BETA-BLOCKER; PERFORMANCE; COLLIMATION; EFFICACY; IMPACT;

D O I：

10.1016/j.ijcard.2010.10.035

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Heart rate (HR) reduction is essential to achieve optimal image quality and diagnostic accuracy with computed tomography coronary angiography (CTCA). Administration of ivabradine could be an attractive alternative to beta-blockade to reduce HR. Methods: One-hundred-twenty-three patients referred for CTCA were prospectively enrolled. Patients were divided in two groups depending on the absence or presence of chronic beta-blockade treatment. Within the two groups patients were randomized to either no additional premedication or oral ivabradine for 5 days prior to CTCA. In presence of chronic beta-blockade therapy it was shifted to atenolol 50 mg twice a day for 5 days prior to CTCA. HR and blood pressure were assessed at admission (T0), immediately before CTCA (T1) and during CTCA (T2). The target HR was <65 bpm. Results: Ivabradine significantly reduced HR during CTCA. Mean relative HR reduction was 15% for controls, 12% for chronic beta-blockade, 19% for ivabradine and 24% for both chronic beta-blockade and ivabradine at T2 (p for trend <0.001). The rate of patients who reached the target HR at T2 was 83% in controls, 71% with chronic beta-blockade, 97% with ivabradine and 97% with both (p for trend <0.05). The percentage of patients that needed additional IV beta-blockade at T1 decreased from 69% to 40% with ivabradine and 30% with both (p for trend <0.05). Conclusions: Ivabradine is safe and effective in increasing the rate of patients at target HR and in reducing the need for additional IV beta-blockade in patients referred for CTCA. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

引用

页码：28 / 33

页数：6

共 32 条

[31] Ivabradine -: the first selective sinus node If channel inhibitor in the treatment of stable angina [J].