Anass Assaidi
Mohammed VI University of Health Science, Morocco
Title: Combination of ivabradine and beta-blockers: Results of an observational study in daily practice in Morocco
Biography
Biography: Anass Assaidi
Abstract
Introduction: Several studies confirm that combining ivabradine with beta-blockers, reduce more effectively the heart rate in patients with heart failure and/or angina than beta-blockers alone.
Methods: Non-interventional cohort study, conducted in Morocco Cardiology clinical practice, in patients with heart failure or angina treated with ivabradine in combination with beta-blockers. The primary outcome, measured at 1 and 4 months, were HR, NYHA classification, and SEATTLE quality of life questionnaire for angina patients.
Results: 497 patients were included, their mean age was 65.6±10.3 years, mean HR was 89.4±14.5 bpm and 61.6% were male. 10.9% treated with less than the initial beta-blockers dosage, 56.8% under initial dosage, 21.9% under less than recommended dosage and 10.4% under recommended dose. After 4 months, the mean HR showed a significant reduction of 27±13.8 bpm (p<0.0001) and no statistical significant difference (p=0.46) observed between beta-blockers dosages which was respectively 26.2±0.8, 28.2±2, 32.2±2, and 26.08±1.3, for initial, recommended, less than initial and less than recommended dosage. 42% of patients became NYHA I, 55% NYHA II, only 4% were NYHA III and no patient remained NYHA IV regardless of BB dosages. There was no-significant difference associated to the BB dose (p=0.53) in the 5 SAQ domain-scores between baseline (V0) and 4 months follow up visit (V2).
Conclusion: In this study, ivabradine was effective in reducing HR in CHF and angina patients over a period of 4 months irrespective of the dose of beta-blockers. There was a marked shift from higher to lower NYHA classes independently of the BB administered dose.