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DOI: 10.1055/s-0028-1119673
© Georg Thieme Verlag KG Stuttgart · New York
BEAUTIfUL-Studie – Analyse der Studienergebnisse
Publication History
Publication Date:
16 March 2009 (online)
Abstract
The results of the BEAUTIfUL-Study presented at the ESC meeting in Munich last year showed the following:
The use of Ivabradine in patients with coronary heart disease and left-ventricular dysfunction in combination with beta-blockers is safe and beneficial as an adjunct to standard therapy. A heart rate ≥ 70 beats/minute is associated with an impaired prognosis regarding cardiovascular death, hospitalisation for heart failure, revascularization and for myocardial infarction, and also regarding the primary composite of cardiovascular death, non-fatal myocardial infarction and hospitalisation for heart failure. As a consequence, heart rate should be routinely assessed in daily practice and taken into account as an additional risk factor. In patients with an initial heart rate ≥ 70 beats/minute, Ivabradine significantly reduces the need for subsequent revascularizations and the number of myocardial infarctions. As an add-on to standard therapy, Ivabradine might exert additional prognostically relevant effects, which complement the known benefical effects on ischaemia-related symptoms in patients with a heart rate > 60 beats/minute.
Literatur
- 1 Wilhelmsen I, Berglund G, Elmfeldt D. et al . The multifactor primary prevention trial in Goteborg, Sweden. Eur Heart J. 1986; 7 279-288
- 2 Palatini P, Casiglia E, Pauletto P. Relation between physical training and ambulatory blood pressure in stage I hypertensive subjects: results of the HARVEST trial. Circulation. 1994; 90 2870-2872
- 3 Diaz A, Bourassa G M, Guertin M C, Tardif J C. Long-term prognostic value of resting heart rate in patients with suspected or proven coronary artery disease. Eur Heart J. 2005; 26 967-974
- 4 Hjalmarson A, Gilpin E, Kjekshus J. et al . Influence of heart rate on mortality after acute myocardial infarction. Am J Cardiol. 1990; 65 547-553
- 5 Kjekshus J, Gullestad L. Heart rate as a therapeutic target in heart failure. Eur Heart J. 1999; 1 (suppl H) H64-H69
- 6 Fox K, Borer J S, Camm A J. et al, for the Heart Rate Working Group . J Am Coll Cardiol. 2007; 50 823-830
- 7 Borer J S. Drug insight: I f inhibitors as specific heart-rate-reducing agents. Nat Clin Pract Cardiovasc Med. 2004; 1 103-109
- 8 Tardif J C, Ford I, Tendera M, Bourassa M G, Fox K. Efficacy of ivabradine, a new selective I(f) inhibitor, compared with atenolol in patients with chronic stable angina. Eur Heart J. 2005; 26 2529-2536
- 9 Fox K, Ford I, Steg G, Tendera M, Ferrari R. on behalf of the BEAUTIFUL investigators . Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebo-controlled trial. Lancet. 2008; 372 807-816
- 10 Fox K, Ford I, Steg G, Tendera M, Ferrari R. on behalf of the BEAUTIFUL investigators . Heart rate as a prognostic risk factor in patients with coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial. Lancet. 2008; 372 817-821
- 11 Cerbai E, Sartiani L, DePaoli P. et al . The properties of the pacemaker current I(f) in human ventricular myocytes are modulated by cardiac disease. J Mol Cell Cardiol. 2001; 33 441-448
- 12 Michels G, Brandt M C, Zagidullin N. et al . Direct evidence for calcium conductance of hyperpolarization-activated cyclic nucleotide-gated channels and human native If at physiological calcium concentrations. Cardiovasc Res. 2008; 78 466-475
- 13 Heusch G, Skyschally A, Gres P. et al . Improvement of regional myocardial blood flow and function and reduction of infarct size with ivabradine-protection beyond heart rate reduction. Eur Heart J. 2008; 29 2265-2275
- 14 Fox K, Garcia M A, Ardissino D. et al . Guidelines on the management of stable angina pectoris: executive summary: the Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Hear J. 2006; 27 1341-1382
- 15 Dickstein K, Cohen-Solal A, Filippatos G. et al . Guidelines for the diagnosis and treatment of acute and chronic heart failure: executive summary: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heartfailure 2008 of the European Society of Cardiology. Eur Hear J. 2008; 29 2388-2442
Dr. med. Dr. Marco Albanese
Prof. Dr. med. Wolfgang Schöls
Klinik für Kardiologie und Angiologie
Herzzentrum Duisburg
Gerrickstraße 21
47137 Duisburg
Email: malbanes@ejk.de