Ivabradine for the Therapy of Chronic Stable Angina Pectoris: a Systematic Review and Meta-Analysis

Christina Kalvelage; Christian Stoppe; Nikolaus Marx; Gernot Marx; Carina Benstoem

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자료유형: 학술저널

저자정보: Christina Kalvelage (RWTH Aachen University) Christian Stoppe (RWTH Aachen University) Nikolaus Marx (RWTH Aachen University) Gernot Marx (RWTH Aachen University) Carina Benstoem (RWTH Aachen University)

저널정보: 대한심장학회 Korean Circulation Journal Korean Circulation Journal Vol.50 No.9

발행연도: 2020.1

수록면: 773 - 786 (14page)

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Background and Objectives: Coronary artery disease (CAD) is the number one cause of death worldwide. The If channel inhibitor ivabradine serves as second line medication for the CAD leading symptom angina pectoris. This systematic review and meta-analysis assess the existing evidence of ivabradine in angina pectoris. Methods: We systematically searched MEDLINE, Embase, CENTRAL, and Web of Science (September 2019) for randomized controlled trials (RCTs) that compared ivabradine versus placebo, standard therapy (ST) or other anti-anginal drugs. Two review authors independently assessed trials for inclusion and performed data extraction. We completed a ‘risk of bias’ assessment for all studies and assessed quality of the trial evidence using the Grading of Recommendations Assessment, Development and Evaluation methodology. We meta-analysed data were applicable and calculated mean differences (MDs) and risk ratios using a random-effects model. Results: A total of 11 RCTs (n=16,039) were included. Compared to placebo/ST, we found significant effects on the frequency of hospitalisation in a small cohort (n=90; hazard ratio [HR], 0.19; 95% confidence interval [CI], 0.04, −0.92; p=0.04), but no effects on cardiovascular mortality (n=19,102; HR, 1.10; 95% CI, 0.94, 1.28; p=0.25) or the frequency of angina pectoris episodes (n=167; weighted MD, −1.06; 95% CI, −2.74, −0.61; p=0.21). Conclusions: The present work makes an important contribution to optimal patient care in angina pectoris by complementing the current European Society of Cardiology guideline—recommending class IIa with evidence level B—decisively with 8 further studies.

#Ivabradine #Angina pectoris #Cardiovascular diseases #Systematic review #Meta-analysis

참고문헌 (30)

참고문헌 신청

Fox K / 2006 / 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 Heart J 27:1341~1381

Task Force Members / 2013 / 2013 ESC guidelines on the management of stable coronary artery disease : the task force on the management of stable coronary artery disease of the European Society of Cardiology / Eur Heart J 34:2949~3003

National Clinical Guidelines Centre / Stable angina: methods, evidence & guidance

European Medicines Agency (EMA) / Product information ivabradine

Picano E / 2002 / Noninvasive pacemaker stress echocardiography for diagnosis of coronary artery disease : a multicenter study / J Am Coll Cardiol 40:1305~1310

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