Long-term safety and efficacy of ivabradine after direct percutaneous coronary intervention in patients with acute myocardial infarction complicated by heart failure: a single-center retrospective study
Abstract Background There are few studies on the long-term efficacy and safety of ivabradine in patients with acute myocardial infarction (AMI) complicated by heart failure. We aimed to assess the above questions and provide clinical experience. Methods The study enrolled patients with AMI complicat...
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BMC
2025-05-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-025-04854-x |
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| author | Xiaohua Guo Wenwen Yang Yingchao Cui Rongxin Guo Yangyang Zhu Tong Liu Kangyin Chen Changle Liu |
| author_facet | Xiaohua Guo Wenwen Yang Yingchao Cui Rongxin Guo Yangyang Zhu Tong Liu Kangyin Chen Changle Liu |
| author_sort | Xiaohua Guo |
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| description | Abstract Background There are few studies on the long-term efficacy and safety of ivabradine in patients with acute myocardial infarction (AMI) complicated by heart failure. We aimed to assess the above questions and provide clinical experience. Methods The study enrolled patients with AMI complicated by heart failure who underwent percutaneous coronary intervention (PCI) from January 2022 to June 2023. Based on the discharge medications, patients were stratified into two groups: (1) the ivabradine group (receiving ivabradine with or without β-blockers) and (2) the β-blocker monotherapy group (control). Efficacy effects included in-hospital heart rate control, all-cause mortality, and heart failure readmission. Safety effects comprised recurrent myocardial infarction and recurrent angina rehospitalization. The initial cohort comprised 517 patients, excluding 62 who discontinued ivabradine, leaving 455 for analysis (ivabradine group: n = 101; β-blocker group: n = 354). Following 1:1 propensity score matching (PSM), 92 matched pairs were available for analysis. Potential confounding variables were adjusted through robust Cox proportional hazards regression modeling. Results Post-treatment, heart rate at discharge significantly decreased in both groups, with the ivabradine group demonstrating lower values than the β-blocker group (P < 0.05). At 2-year follow-up (post- PSM), the ivabradine group showed a reduced risk of heart failure readmission compared to the β-blocker group (hazard ratio [HR]: 0.32; 95% confidence interval [CI]: 0.13–0.77; P = 0.012). However, no significant intergroup difference was observed in all-cause mortality (HR: 1.04; 95% CI: 0.41–2.61; P = 0.937). No significant differences were observed between the two groups in the safety endpoints, including recurrent myocardial infarction or rehospitalization for angina. Conclusion Early administration of ivabradine following PCI in patients with AMI complicated by heart failure can lower resting heart rate and is beneficial in reducing the risk of rehospitalization for heart failure. However, these findings support further investigation in future large prospective studies. Clinical trial number Not applicable. Graphical Abstract |
| format | Article |
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| publishDate | 2025-05-01 |
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| spelling | doaj-art-bb7a33aa3d0f4554880788d06d6b6e642025-08-20T02:39:03ZengBMCBMC Cardiovascular Disorders1471-22612025-05-0125111010.1186/s12872-025-04854-xLong-term safety and efficacy of ivabradine after direct percutaneous coronary intervention in patients with acute myocardial infarction complicated by heart failure: a single-center retrospective studyXiaohua Guo0Wenwen Yang1Yingchao Cui2Rongxin Guo3Yangyang Zhu4Tong Liu5Kangyin Chen6Changle Liu7Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityAbstract Background There are few studies on the long-term efficacy and safety of ivabradine in patients with acute myocardial infarction (AMI) complicated by heart failure. We aimed to assess the above questions and provide clinical experience. Methods The study enrolled patients with AMI complicated by heart failure who underwent percutaneous coronary intervention (PCI) from January 2022 to June 2023. Based on the discharge medications, patients were stratified into two groups: (1) the ivabradine group (receiving ivabradine with or without β-blockers) and (2) the β-blocker monotherapy group (control). Efficacy effects included in-hospital heart rate control, all-cause mortality, and heart failure readmission. Safety effects comprised recurrent myocardial infarction and recurrent angina rehospitalization. The initial cohort comprised 517 patients, excluding 62 who discontinued ivabradine, leaving 455 for analysis (ivabradine group: n = 101; β-blocker group: n = 354). Following 1:1 propensity score matching (PSM), 92 matched pairs were available for analysis. Potential confounding variables were adjusted through robust Cox proportional hazards regression modeling. Results Post-treatment, heart rate at discharge significantly decreased in both groups, with the ivabradine group demonstrating lower values than the β-blocker group (P < 0.05). At 2-year follow-up (post- PSM), the ivabradine group showed a reduced risk of heart failure readmission compared to the β-blocker group (hazard ratio [HR]: 0.32; 95% confidence interval [CI]: 0.13–0.77; P = 0.012). However, no significant intergroup difference was observed in all-cause mortality (HR: 1.04; 95% CI: 0.41–2.61; P = 0.937). No significant differences were observed between the two groups in the safety endpoints, including recurrent myocardial infarction or rehospitalization for angina. Conclusion Early administration of ivabradine following PCI in patients with AMI complicated by heart failure can lower resting heart rate and is beneficial in reducing the risk of rehospitalization for heart failure. However, these findings support further investigation in future large prospective studies. Clinical trial number Not applicable. Graphical Abstracthttps://doi.org/10.1186/s12872-025-04854-xAcute myocardial infarctionIvabradinePercutaneous coronary intervention |
| spellingShingle | Xiaohua Guo Wenwen Yang Yingchao Cui Rongxin Guo Yangyang Zhu Tong Liu Kangyin Chen Changle Liu Long-term safety and efficacy of ivabradine after direct percutaneous coronary intervention in patients with acute myocardial infarction complicated by heart failure: a single-center retrospective study BMC Cardiovascular Disorders Acute myocardial infarction Ivabradine Percutaneous coronary intervention |
| title | Long-term safety and efficacy of ivabradine after direct percutaneous coronary intervention in patients with acute myocardial infarction complicated by heart failure: a single-center retrospective study |
| title_full | Long-term safety and efficacy of ivabradine after direct percutaneous coronary intervention in patients with acute myocardial infarction complicated by heart failure: a single-center retrospective study |
| title_fullStr | Long-term safety and efficacy of ivabradine after direct percutaneous coronary intervention in patients with acute myocardial infarction complicated by heart failure: a single-center retrospective study |
| title_full_unstemmed | Long-term safety and efficacy of ivabradine after direct percutaneous coronary intervention in patients with acute myocardial infarction complicated by heart failure: a single-center retrospective study |
| title_short | Long-term safety and efficacy of ivabradine after direct percutaneous coronary intervention in patients with acute myocardial infarction complicated by heart failure: a single-center retrospective study |
| title_sort | long term safety and efficacy of ivabradine after direct percutaneous coronary intervention in patients with acute myocardial infarction complicated by heart failure a single center retrospective study |
| topic | Acute myocardial infarction Ivabradine Percutaneous coronary intervention |
| url | https://doi.org/10.1186/s12872-025-04854-x |
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