Armed Police Jilin Province General Hospital Inside the Second Department, Changchun, China.
Department of Cardiology, The First Hospital of Jilin University, Changchun, China.
Ann Noninvasive Electrocardiol. 2024 Nov;29(6):e70012. doi: 10.1111/anec.70012.
The efficacy and safety of Ivabradine for patients with acute heart failure (AHF) is controversial, and there are few clinical trials addressing this topic.
We performed this meta-analysis to evaluate efficacy and safety of Ivabradine treatment for patients with acute heart failure. We obtained data for controlled trials using the PubMed, Cochrane Library, EMBASE, and Clinical Trials.gov databases. The efficacy endpoints included change in heart rate, brain natriuretic peptide (BNP) levels, N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, ejection fraction (EF) values, and a 6-min walk distance. The safety endpoints included mortality, cardiogenic mortality, incidents of hospital readmission, bradycardia, and atrial fibrillation. Ten randomized controlled trials (RCTs) met our criteria, and data from 656 patients were included for the study.
Ivabradine treatment significantly decreased heart rate and BNP and NT-proBNP levels compared with those seen in the control group. EF values were significantly increased upon ivabradine treatment. No significant differences were observed in the endpoints of the 6-min walk distance, all-cause mortality, cardiogenic mortality, incidents of hospital readmission, bradycardia, and atrial fibrillation data between ivabradine treated and control groups.
Ivabradine can reduce heart rate and BNP and NT-pro BNP levels and elevate EF values and 6-min walk distance data significantly in acute heart failure patients. It also exhibits a stable safety profile, with similar risks of all-cause mortality, cardiogenic mortality, incidents of readmission, and major adverse cardiovascular effects compared with those of the control group.
伊伐布雷定治疗急性心力衰竭（AHF）的疗效和安全性存在争议，针对这一主题的临床试验较少。
我们进行了这项荟萃分析，以评估伊伐布雷定治疗急性心力衰竭患者的疗效和安全性。我们使用 PubMed、Cochrane 图书馆、EMBASE 和 ClinicalTrials.gov 数据库获取了对照试验的数据。疗效终点包括心率变化、脑钠肽（BNP）水平、N 末端脑钠肽前体（NT-proBNP）水平、射血分数（EF）值和 6 分钟步行距离。安全性终点包括死亡率、心源性死亡率、住院再入院事件、心动过缓以及心房颤动。符合我们标准的有 10 项随机对照试验（RCT），共有 656 名患者的数据纳入了该研究。
与对照组相比，伊伐布雷定治疗可显著降低心率和 BNP 及 NT-proBNP 水平。伊伐布雷定治疗可显著提高 EF 值。在 6 分钟步行距离、全因死亡率、心源性死亡率、住院再入院事件、心动过缓和心房颤动数据的终点方面，伊伐布雷定治疗组与对照组之间未观察到显著差异。
伊伐布雷定可显著降低急性心力衰竭患者的心率和 BNP 及 NT-proBNP 水平，提高 EF 值和 6 分钟步行距离。与对照组相比，它还具有稳定的安全性，全因死亡率、心源性死亡率、再入院事件和主要不良心血管事件的风险相似。
