Pathak Atul, Berdeaux Alain, Mulder Paul, Thuillez Christian
Service de Pharmacologie Clinique, Inserm U 858, Faculté de Médecine, Toulouse, France.
Therapie. 2010 Sep-Oct;65(5):483-9. doi: 10.2515/therapie/2010062. Epub 2010 Dec 13.
The present paper reviews clinical evidence underlining the role of ivabradine in the management of patient with ischemic heart disease. Reduction in heart rate mediated by this selective I(f) current inhibitor has been associated with anti-ischemic efficacy without any effect on haemodynamic or myocardial contractility. The antianginal efficacy of ivabradine is similar or superior to that of conventional anti-ischemic agents. Moreover combination therapy with ivabradine provides substantial benefit in patients already receiving beta-blocker. Prognostic efficacy of ivabradine is evaluated in a large program of studies, among which BEAUTIFUL in coronary patients with left ventricular dysfunction. The SIGNIFY study is ongoing in stable coronary patients without ventricular dysfunction. Furthermore the SHIFT trial will evaluate ivabradine benefits in heart failure patients, whatever the origin, ischemic or not.
本文综述了强调伊伐布雷定在缺血性心脏病患者管理中作用的临床证据。这种选择性I(f)电流抑制剂介导的心率降低与抗缺血疗效相关，而对血流动力学或心肌收缩力无任何影响。伊伐布雷定的抗心绞痛疗效与传统抗缺血药物相似或更优。此外，伊伐布雷定联合治疗对已接受β受体阻滞剂治疗的患者有显著益处。伊伐布雷定的预后疗效在一个大型研究项目中进行评估，其中包括针对左心室功能障碍冠心病患者的BEAUTIFUL研究。SIGNIFY研究正在无心室功能障碍的稳定冠心病患者中进行。此外，SHIFT试验将评估伊伐布雷定对心力衰竭患者的益处，无论其病因是缺血性还是非缺血性。
