Treatment of angina patients with ivabradine reduces risk of cardiovascular death

MONTREAL HEART INSTITUTEOct 29 2009

Dramatic reductions in hospitalization for heart attacks and in the need for revascularization surgery were achieved in angina patients treated with the selective heart rate reduction medication ivabradine on top of current standard treatment, according to results of a major clinical study presented today at the 2009 Canadian Cardiovascular Congress in Edmonton.

Results of a new sub-analysis of the BEAUTIfUL study were presented by the Canadian national coordinator, Dr. Jean-Claude Tardif, director of the Montreal Heart Institute Research Centre and professor of medicine at the Université de Montréal. They show that the risk of hospitalization for heart attack was reduced by 42% in angina patients treated with ivabradine in addition to conventional treatment, compared to those given placebo plus conventional treatment. In those patients whose heart rate at the start of the study was high (greater than 70 beats per minute), there was a 73% reduction in hospitalization for heart attack. The need for coronary revascularization surgery was also reduced in patients receiving ivabradine, decreasing by 30% in all angina patients and by 59% in those with a high initial heart rate.

Overall, the study showed that treatment of angina patients with ivabradine reduced the risk of cardiovascular death, hospitalization for heart attack or new or worsening heart failure by 24% in all angina patients and by 31% in those with an initial high heart rate. The study included 1,507 patients with angina, of whom 734 received ivabradine and 773 placebo in addition to conventional treatment. Of these, 712 across both groups had an initial high heart rate. Patients were followed for a median time of 18 months.

"These are important new results that increase our understanding of how lowering heart rate with ivabradine can not only treat angina, but also potentially play a major role in reducing subsequent major cardiovascular events," said Dr. Tardif. "This could have important implications in our future treatment of angina patients and prevention of major complications, for the benefit of patients and the healthcare system."

Ivabradine is not yet available for clinical use in Canada.