The efficiency of Ivabradine therapy in heart failure in elderly patients / 中华老年医学杂志

ABSTRACT

Objectives To evaluate the efficacy and safety of administering Ivabradine in the elder patients with chronic heart failure(HF).Methods Totally 52 outpatients with chronic stable HF in Fuwai Hospital and Anzhen Hospital from August 2015 to February 2016,with heart rates (HR)of ＞70 bpmafter optimized medical therapy were selected and administrated Ivabradine for 3 months(Ivabradine group).50 patients who received optimized medical therapy except Ivabradine for economic or other reasons were recruited as control group during the same period.Initial dose of Ivabradine was 2.5 mg two times a day,up to a maximum of 7.5 mg two times a day,adjusting the dose according to HR.Resting HR of the patients was maintained around 60 beats/min and not lower than 55 beats/min.HR,N-terminal pro-brain natriuretic peptide (NT-proBNP),6-minute walk distance,Minnesota heart failure quality of life(MLHFQ),left ventricular ejection fraction(LVEF) and adverse effects were recorded.Results At baseline,no significant differences were found in HR,NT-proBNP,the scores of MLHFQ,6-minute walk distance (all P＞ 0.05) between Ivabradine group and control group.After 3 months of treatment,compared with control group,Ivabradine group showed significantly decreased levels of HR,the scores of MLHFQ and NT-proBNP(allP＜0.01),and significantly increased 6-minute walk distance and LVEF(all P＜0.01).Compared with baseline data,Ivabradine treatment showed the decreased levels of HR [(69.5 ± 10.2)bpm vs.(80.2 ± 7.8)bpm,P＜0.05],the scores of MLHFQ [(14.9±4.3)scores vs.(23.5±6.2)scores(P＜0.05)]and NT-proBNP [1 682 ng/L (212-3 628) vs.2 450 (254-5 344) ng/L,P ＜ 0.05] significantly,and showed the significantly increased levels of 6-minute walk distance [(386.4 ± 101.8)m vs.(282.9 ± 86.3)m,P＜ 0.05]and LVEF [(40.0±6.0)％vs.(31.0±7.0)％ (P＜0.05)].Few adverse effects were recorded.Conclusions In elderly outpatients with stable HF,Ivabradine treatment is effective and safe.