Heart rate-lowering efficacy and respiratory safety of ivabradine in patients with obstructive airway disease: a randomized, double-blind, placebo-controlled, crossover study
American Journal of Cardiovascular Drugs,  Clinical Article

Majewski S et al. – This study demonstrated that selective heart rate (HR) reduction with ivabradine is effective in patients with asthma and chronic obstructive pulmonary disease (COPD), with no alteration in respiratory function or symptoms over the duration of the study. Ivabradine offers an interesting alternative, as an HR–lowering agent, in patients with respiratory disease and contraindications to β–blockers.

Methods
  • This was a randomized, single–center, double–blind, placebo–controlled, crossover trial.
  • Enrolment began in May 2009, and the last patient completed the study in January 2011.
  • The study was conducted in an ambulatory setting.
  • A total of 40 patients completed the study (20 asthmatic patients and 20 COPD patients).
  • Inclusion criteria were: documented diagnosis of asthma or COPD according to international guidelines, age 18–75 years, and mean HR on Holter ECG recording of ≥60beats/min.
  • Exclusion criteria included disease exacerbation in a previous month or inability to understand instructions on the study procedures.
  • All patients received ivabradine 7.5mg twice daily for 5 days and placebo twice daily for 5 days in a crossover manner, in one of the two arms of the study, with at least 2 days of washout between treatments.
  • The main outcome measures included the difference in HR between ivabradine and placebo treatment and change in HR in comparison with baseline.
  • Other evaluated outcomes were differences in the peak expiratory flow rate (PEFR), the daily symptom score, rescue medication consumption, and AEs.

Results
  • Ivabradine produced significantly lower mean HR than placebo in both groups of patients: asthma 67.4±8.38 versus 82.85±11.19beats/min (p<0.001) and COPD 69.75±8.9 versus 81.05±9.75beats/min (p<0.001).
  • Similar results were observed for the minimal HR as well as for the maximal noted HR.
  • In comparision with baseline, ivabradine significantly reduced HR in both groups of studied patients (all p<0.05), whereas placebo did not have such an effect.
  • No significant difference, in either the asthma or the COPD group, was found between ivabradine and placebo in morning and evening peak expiratory flow rate, peak expiratory flow diurnal variability, daily symptom scores, and rescue medication usage (all p>0.05).
  • Both treatments were well tolerated.
  • The incidence of AEs was low and generally similar in both periods of treatment, except for visual symptoms during treatment with ivabradine, which was reported by 5% of the patients.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Nurse Practitioner

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Nurse Practitioner Articles

1 Vitamin D and sleep disorders Full Text Nature and Science of Sleep, August 13, 2014    Free full text    Clinical Article

2 Blood pressure in relation to coffee and caffeine consumption Current Hypertension Reports, August 8, 2014    Review Article

3 Vitamin D and the risk of dementia and Alzheimer's disease Neurology®, August 27, 2014    Clinical Article

4 Partly replacing meat protein with soy protein alters insulin resistance and blood lipids in postmenopausal women with abdominal obesity The Journal of Nutrition, July 23, 2014    Clinical Article

5 Coffee consumption and mortality from all causes, cardiovascular disease, and cancer: a dose-response meta-analysis American Journal of Epidemiology, August 26, 2014    Evidence Based Medicine    Review Article

6 Reading and listening to music increase resting energy expenditure during an indirect calorimetry test Journal of the Academy of Nutrition and Dietetics, August 29, 2014    Clinical Article

7 Nut consumption for vascular health and cognitive function Nutrition Research Reviews, July 11, 2014    Review Article

8 Regular fish consumption and age-related brain gray matter loss American Journal of Preventive Medicine, August 15, 2014    Clinical Article

9 Vitamin D and melanoma and non-melanoma skin cancer risk and prognosis: A comprehensive review and meta-analysis European Journal of Cancer, August 7, 2014    Review Article

10 Soda consumption and risk of hip fractures in postmenopausal women in the Nurses’ Health Study American Journal of Clinical Nutrition, August 18, 2014    Clinical Article

11 Nut consumption and the risk of coronary artery disease: A dose–response meta-analysis of 13 prospective studies Thrombosis Research, August 14, 2014    Clinical Article

12 Processed and unprocessed red meat consumption and hypertension in women American Journal of Clinical Nutrition, August 11, 2014    Clinical Article

13 Meta-analysis of black tea consumption and breast cancer risk: update 2013 Nutrition and Cancer, August 6, 2014    Evidence Based Medicine

14 Egg consumption is associated with increased risk of ovarian cancer: Evidence from a meta-analysis of observational studies Clinical Nutrition, August 5, 2014    Evidence Based Medicine

15 Topical ginger treatment with a compress or patch for osteoarthritis symptoms Journal of Holistic Nursing, August 20, 2014    Clinical Article
Exclusive Author Commentary

16 Impact of dairy consumption on essential hypertension: A clinical study Full Text Nutrition Journal, August 29, 2014    Free full text    Clinical Article

17 Effect of omega-3 fatty acids on kidney function after myocardial infarction: The Alpha Omega Trial Clinical Journal of the American Society of Nephrology, August 12, 2014    Clinical Article
Exclusive Author Commentary

18 Effects of a eucaloric reduced-carbohydrate diet on body composition and fat distribution in women with PCOS Metabolism, July 22, 2014    Clinical Article

19 Re-evaluating the role of antidepressants in cancer-related depression: A systematic review and meta-analysis General Hospital Psychiatry, June 3, 2014    Evidence Based Medicine

20 Psychometric properties of the Italian Yale Food Addiction Scale in overweight and obese patients Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, August 4, 2014    Clinical Article
Exclusive Author Commentary

Indexed Journals in Nurse Practitioner: Journal of the American Academy of Nurse Practitioners, Holistic Nursing Practicemore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close