Abstract 20934: Ivabradine Is Safe and Efficient for the Treatment of Stable Angina Pectoris in Octogenarians
Objectives: The REDUCTION multicentre study evaluated the efficacy and safety of ivabradine in stable angina in routine clinical practice. In patients over 80 years (octogenarians) there is an increased incidence of bradycardia due to age-related alteration of the sinus node, AV node and of the conduction system. In this subgroup analysis, the efficacy and safety of ivabradine was evaluated in octogenarians.
Methods: 382 octogenarians with chronic stable angina pectoris were followed for a mean of 4 months. Patients were treated with ivabradine twice daily (bid) in flexible doses (2.5, 5 or 7.5 mg bid). After baseline evaluation two consecutive visits were conducted after 1 and 4 months. At each visit doses could be increased to further reduce heart rate. Heart rate (HR) during rest, the number of angina attacks, nitrate consumption, overall efficacy and tolerance according to the physicians judgement were evaluated.
Results: 382 octogenarians (intention to treat, mean age 83 ± 2.9 years, 42.3% male) with chronic stable angina pectoris were analyzed. 45% of the patients had undergone a PCI or CABG before and 35% had a myocardial infarction in their history. Almost all patients received concomitant standard medication. At baseline, mean HR was 82.8 ± 15.5 bpm and 81% of patients had at least one angina attack per week. Overall a mean of 3.0 ± 4.6 angina attacks per week were reported and consumption of short-acting nitrates was 4.2 ± 5.1 units per week. After 4 months of treatment, ivabradine reduced HR by 11.9 ± 12 bpm in a mean dose of 9.4 mg per day. The number of angina attacks was reduced by 73% and nitrate consumption by 74%, respectively. Four pts (1.0%) reported suspected adverse drug reactions (ADR). In one patient a syncope occured. The patient completely recovered. There was no symptomatic bradycardia reported. For 95% of patients physicians considered the efficacy of ivabradine as “very good/good”. For 99% of patients the tolerance was rated as “very good/good”.
Conclusions: The results demonstrate the efficacy of ivabradine in reducing heart rate, number of angina attacks and nitrate consumption in octogenarian patients. The treatment of angina pectoris with ivabradine was effective, safe and was very well tolerated without relevant bradycardia.
- © 2010 by American Heart Association, Inc.