COMPARATIVE PHARMACODYNAMIC CHARACTERISTICS OF IVABRADINE IN PATIENTS WITH CORONARY ARTERY DISEASE: STABLE ANGINA
DOI:
https://doi.org/10.17605/Keywords:
electrophysiological, metoprolol, hemodynamicsAbstract
According to WHO estimates, annual mortality from all cardiovascular diseases (CVDs) is about 17 million people, with coronary artery disease (CAD) being the leading cause. In 2008, the total number of deaths from CAD worldwide reached 7.25 million, representing 12.8% of all deaths. In Russia, CAD accounts for 28% of outpatient and inpatient visits related to all CVDs. Among CAD risk factors, heart rate (HR) plays a significant role. An elevated HR contributes to myocardial ischemia and is a major predictor of CVD development, especially in men. The risk of death from CVD increases significantly when HR exceeds 84 bpm and decreases when HR falls below 60 bpm. First-line anti-ischemic drugs for CAD patients are beta-blockers. By reducing HR, prolonging diastole, and improving myocardial perfusion, beta-blockers reduce myocardial oxygen demand and help alleviate ischemia. In our study, patients were most commonly treated with bisoprolol (56.09% ±0.49) and metoprolol tartrate. However, beta-blockers have several side effects limiting their use in patients with comorbidities: worsening airway obstruction in asthma and COPD, reduced peripheral circulation, hypotension, and conduction disorders. Therefore, the development of a new drug class targeting the If-channels of the sinoatrial node presents a promising alternative for treating stable angina and heart failure. Ivabradine is the first representative of this class. It reduces HR without negatively impacting myocardial contractility, hemodynamics, or cardiac electrophysiological properties
References
1. ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2021: The Task Force for
the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology.
Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European
Society of Intensive Care Medicine (ESICM). Eur. Heart J. – 2018. – Vol. 29, No. 19. – pp. 2388–2442.
2. Diagnosis and Treatment of Chronic Heart Failure. National Clinical Guidelines. Ed. by R.G. Oganov. – 3rd
edition. – Moscow, 2020. – pp. 67–160.
3. The European Health Report 2019: Health and Health Systems 2017. – Available at: www.euro.who.int
4. Cleland J.G., Swedberg K., Follath F. et al. Eur. Heart J. – 2024. – Vol. 24, No. 5. – pp. 442–463.
5. Fox K., Borer J.S., Camm J. et al. J. Am. Coll. Cardiol. – 2019. – Vol. 50. – pp. 823–830.
6. Fox K., Garcia M.A., Ardissino D. et al. Eur. Heart J. – 2021. – Vol. 27. – pp. 1241–1381.
7. Mulder P., Barbier S., Chagraoui A. et al. Circulation. – 2017. – Vol. 109. – pp. 1674–1679.
8. Fox K., Ferrari R., Tendera M. et al. Am. Heart J. – 2022. – Vol. 152, No. 5. – pp. 860–866.
9. Tardif C., Berry C. Eur. Heart J. – 2016. – Vol. 8 (Suppl. D). – pp. D24–D29.
10. Steg P.G. Medicographia. – 2019. – Vol. 4, No. 31. – pp. 371–376.
11. Drouin A., Gendron M.E., Thorin E. et al. Br. J. Pharmacol. – 2020. – Vol. 154, No. 4. – pp. 749–757.
12. Ferrari R., Nesta F., Boraso A. Eur. Heart J. – 2015. – Vol. 1. – pp. H24–H28.
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