Comparison of the safety and efficacy of ivabradine and nebivolol mono- and combination therapies in the treatment of stable angina pectoris patients with left ventricular dysfunction

  • Rasim Kutlu Gümüshane State Hospital, Department of Cardiology, Gümüshane
  • Mehmet Erdem Memetoglu Gümüshane State Hospital, Department of Cardiovascular Surgery, Gümüshane
  • Tolkun Murataliev Muratalievic Department of Cardiology, National Cardiology and Internal Medicine Institude, Bishkek
Keywords: Chronic heart failure, Ivabradine, Nebivolol, Stable angina pectoris

Abstract

We aimed to investigate the pharmacoeconomic efficacy of ivabradine and nebivolol in treatment of stable angina pectoris patients with left ventricular dysfunction prospectively. Pharmacoeconomic analysis was performed by using cost minimization analysis, and cost effectiveness analysis. After 6 months treatment LVEF for the nebivolol group (17 patients, 50%) improved by (38 ± 6.5) to (41 ± 3.2), (p>0.05) and for the ivabradine group (17 patients, 50%) (37 ± 5.4) to (41 ± 2.3), (p>0.05), mean MET value in the nebivolol group increased from (3.7 ± 1.2) to (5.5 ± 1.6), (p>0.05), versus from (3.6 ± 1.5) to (5.5 ± 1.4), (p>0.05) in the ivabradine group, cost minimization analysis results showed a difference in the total cost of treatment was US$ 5288.7 in favor of nebivolol. The findings suggest that nebivolol is more cost-effective than ivabradine in the treatment of patients with left ventricular dysfunction.

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References

Akhmetzianova ÉKh, Ga?nitdinova VV, Bakirov AB, Bogoroditskaia OA, Timershina IR. Effect of ivabradine on pulmonary hypertension in chronic obstructive pulmonary disease. Kardiologiia 2012; 52: 41-46.

Amosova E, Andrejev E, Zaderey I, et al. Efficacy of ivabradine in combination with beta-blocker versus uptitration of beta-blocker in patients with stable angina. Cardiovasc Drugs Ther 2011; 25: 531-37.

Arrebola-Moreno A, Dungu J, Kaski JC. Treatment strategies for chronic stable angina. Expert Opin Pharmacother 2011; 12: 2833-44.

Ashrafian H, Violaris AG. Beta-blocker therapy of cardiovascular diseases in patients with bronchial asthma or COPD: The pro viewpoint. Prim Care Respir J. 2005; 14: 236-41.

Borer JS, Böhm M, Ford I, et al. Effect of ivabradine on recurrent hospitalization for worsening heart failure in patients with chronic systolic heart failure: the SHIFT Study. Eur Heart J. 2012; 33: 2813-20.

Camsari A, Arikan S, Avan C, et al. Metoprolol, a beta-1 selective blocker, can be used safely in coronary artery disease patients with chronic obstructive pulmonary disease. Heart Vessels. 2003; 18: 188-92.

Curkendall SM, De Luise C, Jones JK, et al. Cardiovascular disease in patients with chronic obstructive pulmonary disease. Ann Epidemiol. 2006; 16: 63-70.

De Luca G. ?vabradine and diastolic heart failure. Am Coll Cardiol. 2012; 59: E1009.

Fox K, Garcia MA, Ardissino D, et al. Guidelines on the management of stable angina pectoris: executive summary: The task force on the management of stable angina pectoris of the European Society of Cardiology. Eur Heart J. 2006; 27: 1341-81.

Fraker TD Jr, Fihn SD, Gibbons RJ, et al. 2007 chronic angina focused update of the ACC/AHA 2002 guidelines for the management of patients with chronic stable angina: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 guidelines for the management of patients with chronic stable angina. J Am Coll Cardiol. 2007; 50: 2264-74.

Kim Fox, Ian Ford, P Gabriel Steg, et al. Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): A randomised, double-blind, placebo-controlled trial. Lancet 2008; 372: 807-16.

Mapel DW, Dedrick D, Davis K, et al. Trends and cardiovascular comorbidities of COPD patients in the Veterans Administration Medical System, 1991-1999. COPD. 2005; 2: 35-41.

Sidney S, Sorel M, Quesenberry CP, et al. COPD and incident cardiovascular disease hospitalizations and mortality: Kaiser Permanente Medical Care Program. Chest 2005; 128: 2068-75.

Swedberg K, Komajda M, et al. Ivabradine and outcomes in chronic heart failure (SHIFT): A randomised placebo-controlled study. Lancet 2010; 376: 875-85.

Tardif JC, Ponikowski P, Kahan T, ASSOCIATE Study Investigators. Efficacy of the I(f) current inhibitor ivabradine in patients with chronic stable angina receiving beta-blocker therapy: A 4-month, randomized, placebo-controlled trial. Eur Heart J. 2009; 30: 540-48.

Tatarchenko IP, Pozdniakova NV, Biriuchenko MV, et al. Clinical efficacy of ivabradin and nebivolol addition in combined treatment of ischemic heart disease patients with left ventricular dysfunction. J Ter Arkh. 2008; 80: 40-44.

Akhmetzianova ÉKh, Ga?nitdinova VV, Bakirov AB, Bogoroditskaia OA, Timershina IR. Effect of ivabradine on pulmonary hypertension in chronic obstructive pulmonary disease. Kardiologiia 2012; 52: 41-46.

Amosova E, Andrejev E, Zaderey I, et al. Efficacy of ivabradine in combination with beta-blocker versus uptitration of beta-blocker in patients with stable angina. Cardiovasc Drugs Ther 2011; 25: 531-37.

Arrebola-Moreno A, Dungu J, Kaski JC. Treatment strategies for chronic stable angina. Expert Opin Pharmacother 2011; 12: 2833-44.

Ashrafian H, Violaris AG. Beta-blocker therapy of cardiovascular diseases in patients with bronchial asthma or COPD: the pro viewpoint. Prim Care Respir J. 2005; 14: 236-41.

Borer JS, Böhm M, Ford I, et al. Effect of ivabradine on recurrent hospitalization for worsening heart failure in patients with chronic systolic heart failure: the SHIFT Study. Eur Heart J. 2012; 33: 2813-20.

Camsari A, Arikan S, Avan C, et al. Metoprolol, a beta-1 selective blocker, can be used safely in coronary artery disease patients with chronic obstructive pulmonary disease. Heart Vessels. 2003; 18: 188-92.

Curkendall SM, De Luise C, Jones JK, et al. Cardiovascular disease in patients with chronic obstructive pulmonary disease. Ann Epidemiol. 2006; 16: 63-70.

De Luca G. Ivabradine and diastolic heart failure. Am Coll Cardiol. 2012; 59: E1009.

Fox K, Garcia MA, Ardissino D, et al. Guidelines on the management of stable angina pectoris: Executive summary: The task force on the management of stable angina pectoris of the European Society of Cardiology. Eur Heart J. 2006; 27: 1341-81.

Fraker TD Jr, Fihn SD, Gibbons RJ, et al. 2007 chronic angina focused update of the ACC/AHA 2002 guidelines for the management of patients with chronic stable angina: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 guidelines for the management of patients with chronic stable angina. J Am Coll Cardiol. 2007; 50: 2264-74.

Kim Fox, Ian Ford, P Gabriel Steg, et al. Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): A randomised, double-blind, placebo-controlled trial. Lancet 2008; 372: 807-16.

Mapel DW, Dedrick D, Davis K, et al. Trends and cardiovascular comorbidities of COPD patients in the Veterans Administration Medical System, 1991-1999. COPD. 2005; 2: 35-41.

Sidney S, Sorel M, Quesenberry CP, et al. COPD and incident cardiovascular disease hospitalizations and mortality: Kaiser Permanente Medical Care Program. Chest 2005; 128: 2068-75.

Swedberg K, Komajda M, et al. Ivabradine and outcomes in chronic heart failure (SHIFT): A randomised placebo-controlled study. Lancet 2010; 376: 875-85.

Tardif JC, Ponikowski P, Kahan T, ASSOCIATE Study Investigators. Efficacy of the I(f) current inhibitor ivabradine in patients with chronic stable angina receiving beta-blocker therapy: A 4-month, randomized, placebo-controlled trial. Eur Heart J. 2009; 30: 540-48.

Tatarchenko IP, Pozdniakova NV, Biriuchenko MV, et al. Clinical efficacy of ivabradin and nebivolol addition in combined treatment of ischemic heart disease patients with left ventricular dysfunction. J Ter Arkh. 2008; 80: 40-44.

Published
2013-06-19
How to Cite
Kutlu, R., M. Memetoglu, and T. Muratalievic. “Comparison of the Safety and Efficacy of Ivabradine and Nebivolol Mono- and Combination Therapies in the Treatment of Stable Angina Pectoris Patients With Left Ventricular Dysfunction”. Bangladesh Journal of Pharmacology, Vol. 8, no. 3, June 2013, pp. 283-91, doi:10.3329/bjp.v8i3.15118.
Section
Clinical Trial