Current Vascular Pharmacology

Dimitri P. Mikhailidis  
Academic Head, Deptartment of Clinical Biochemistry
Royal Free Hospital Campus
University College London Medical School
University College London (UCL)
Pond Street
London, NW3 2QG
UK

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Impact of Ivabradine on Health-Related Quality of Life of Patients with Ischaemic Chronic Heart Failure

Author(s): Mansour Sallam, Tariq Al-Saadi, Latifa Alshekaili, Ibrahim Al-Zakwani.

Graphical Abstract:


Abstract:

Objective: Chronic heart failure (CHF) remains a major health problem, with high levels of morbidity and mortality and a low health-related quality of life (HRQoL). We assessed the impact on HRQoL of adding the If channel blocker, ivabradine, to a standard treatment regimen of patients with ischaemic CHF (I-CHF) and heart rate (HR) ≥70 beats/min (bpm).

Methods: A randomized prospective study of 100 consecutive patients presenting with stable I-CHF, left ventricular ejection fraction (LVEF) <40% and a sinus HR ≥70 bpm. New York Heart Association (NYHA) class, overall summary score (OSS) and clinical summary score (CSS) of the Kansas City Cardiomyopathy Questionnaire (KCCQ) were used to assess HRQoL. The patients were randomized into 2 groups: carvedilol only (group I (n=50)) and carvedilol + ivabradine (group II (n=50)). The patients were followed up for 12 weeks and their HRQoL scores were monitored and compared.

Results: The overall mean age of the cohort was 63±10 years with 70% (n=70) males. HRQoL scores had significantly improved in group II after 12 weeks of follow-up. The net proportion of patients with a 5-point improvement in CSS was 30% higher in group II (p=0.002), whereas that for the OSS, it was 24% (p=0.001), when compared with group I. These improvements were accompanied by a significant HR reduction (69 vs 78 bpm; p=0.002).

Conclusion: Adding ivabradine to the standard drug regimen, currently advocated by guidelines for CHF with a heart rate ≥70 bpm, resulted in a significant improvement in HRQoL.

Keywords: Quality of life, ischaemic heart failure, ivabradine, carvedilol, heart rate, Kansas City Cardiomyopathy Questionnaire, Oman.

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Article Details

VOLUME: 14
ISSUE: 5
Year: 2016
Page: [481 - 486]
Pages: 6
DOI: 10.2174/1570161114666160505143003
Price: $58