Pharmacy Practice Department, Faculty of Pharmacy, Alexandria University, Al Mesallah Sharq, Qism Bab Sharqi, Alexandria, Alexandria Governorate, Egypt.
Cardiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Eur J Clin Pharmacol. 2022 Jun;78(6):943-954. doi: 10.1007/s00228-022-03290-6. Epub 2022 Mar 3.
Heart rate reduction (HR) is a cornerstone in heart failure therapy as it improves patient outcomes. The aim of this study is to evaluate short-term effect of ivabradine on NT-Pro BNP and neopterin in heart failure patients and assess the association between HR and these biomarkers.
Sixty patients on standard heart failure therapy were randomly allocated into ivabradine group (n = 30) and non-ivabradine group (n = 30). Ivabradine 5 mg twice daily was given for 3 months. Lipid profile and kidney functions were performed and blood samples for NT-Pro BNP and neopterin were analysed at baseline and after 3 months of intervention in both groups.
There was a significant improvement in NYHA class in ivabradine group (p < 0.001). Ejection fraction was improved in ivabradine and non-ivabradine groups after intervention (p < 0.001), with a greater improvement in ivabradine group (p = 0.026). Heart rate was reduced in ivabradine group (p < 0.001) and non-ivabradine group (p < 0.001) yet greater reduction was seen in ivabradine group (p < 0.001). Serum creatinine and blood urea nitrogen were reduced in ivabradine group (Scr: p = 0.001, BUN: p = 0.001). NT-Pro BNP and neopterin levels significantly decreased in ivabradine group (NT-Pro BNP: p < 0.001, neopterin p < 0.001). Significant positive correlation was found between HR and biomarker levels after intervention (NT-Pro BNP: r = 0.475, p < 0.001, neopterin: r = 0.384, p = 0.002).
Ivabradine therapy reduced levels of both biomarkers which correlated well with HR. Biomarker levels might provide a tool for assessing ivabradine effectiveness in HF. Trial registration Date: June 26, 2020. Identifier: NCT04448899. Link: Ivabradine in Patients with Congestive Heart Failure-Full Text View-ClinicalTrials.gov.
心率降低（HR）是心力衰竭治疗的基石，因为它可以改善患者的预后。本研究的目的是评估伊伐布雷定对心力衰竭患者 NT-Pro BNP 和新蝶呤的短期影响，并评估 HR 与这些生物标志物之间的相关性。
60 名接受标准心力衰竭治疗的患者被随机分配到伊伐布雷定组（n=30）和非伊伐布雷定组（n=30）。伊伐布雷定 5mg，每日两次，连续治疗 3 个月。在两组中均于基线和干预 3 个月后进行血脂谱和肾功能检查，并分析 NT-Pro BNP 和新蝶呤的血样。
伊伐布雷定组的纽约心脏协会（NYHA）心功能分级显著改善（p<0.001）。伊伐布雷定组和非伊伐布雷定组的射血分数在干预后均有所改善（p<0.001），伊伐布雷定组的改善更显著（p=0.026）。伊伐布雷定组（p<0.001）和非伊伐布雷定组（p<0.001）的心率均降低，但伊伐布雷定组的降低更显著（p<0.001）。伊伐布雷定组的血肌酐和血尿素氮降低（Scr：p=0.001，BUN：p=0.001）。伊伐布雷定组的 NT-Pro BNP 和新蝶呤水平显著降低（NT-Pro BNP：p<0.001，新蝶呤：p<0.001）。干预后发现 HR 与生物标志物水平之间存在显著正相关（NT-Pro BNP：r=0.475，p<0.001，新蝶呤：r=0.384，p=0.002）。
伊伐布雷定治疗降低了两种生物标志物的水平，与 HR 相关性良好。生物标志物水平可能为评估伊伐布雷定在 HF 中的疗效提供工具。
2020 年 6 月 26 日。标识符：NCT04448899。链接：充血性心力衰竭患者的伊伐布雷定-全文视图-ClinicalTrials.gov。
