TY - JOUR
T1 - Incremental value and safety of oral ivabradine for heart rate reduction in computed tomography coronary angiography
AU - Guaricci, Andrea I.
AU - Schuijf, Joanne D.
AU - Cademartiri, Filippo
AU - Brunetti, Natale Daniele
AU - Montrone, Deodata
AU - Maffei, Erica
AU - Tedeschi, Carlo
AU - Ieva, Riccardo
AU - Di Biase, Luigi
AU - Midiri, Massimo
AU - MacArini, Luca
AU - Di Biase, Matteo
PY - 2012/4/5
Y1 - 2012/4/5
N2 - 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.
AB - 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.
KW - Computed tomography coronary angiography
KW - Coronary heart disease
KW - Heart rate reduction
KW - Ivabradine
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U2 - 10.1016/j.ijcard.2010.10.035
DO - 10.1016/j.ijcard.2010.10.035
M3 - Article
C2 - 21095627
AN - SCOPUS:84858078785
SN - 0167-5273
VL - 156
SP - 28
EP - 33
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 1
ER -