RT Journal Article
SR Electronic
T1 Late-breaking abstract: HR-lowering efficacy and respiratory safety of ivabradine in patients with obstructive airway disease
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 4865
VO 38
IS Suppl 55
A1 Sebastian Majewski
A1 Sebastian Slomka
A1 Ewa Wyderkiewicz-Zielinska
A1 Maciej Ciebiada
A1 Pawel Gorski
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/4865.abstract
AB Aim: There is substantial evidence that heart rate (HR) is a powerful predictor of mortality in both normal individuals and in patients with cardiovascular disease. β-blockers confirmed importance of lowering elevated HR for patients prognosis. However, due to risk of bronchoconstriction, are contraindicated in obstructive airway diseases. Ivabradine, a new If inhibitor which acts specifically on the sino-atrial node, is a pure HR-lowering agent. The objective of this study was to assess efficacy and respiratory safety of ivabradine in patients with asthma and chronic obstructive pulmonary disease (COPD).Methods: In this double blind, placebo-controlled, crossover study, 20 asthmatics and 20 COPD patients received ivabradine 7,5 mg b.i.d. and placebo b.i.d. for 5 days in crossover manner. HR in ECG holter monitoring, peak expiratory flow rate (PEFR), symptoms, rescue medication consumption and adverse events (AEs) were evaluated.Results: Ivabradine produced significantly lower mean HR than placebo in all patients: asthma 67,4±8,38 vs 82,85±11,19 (P=0,000016) and COPD 69,75±8,9 vs 81,05±9,75 (P=0,000470). No significant difference was found between ivabradine and placebo in morning and evening PEFR, PEF diurnal variability, symptom scores and rescue medication usage (all P>0,05). The incidence of AEs was low and generally similar in both treatments, except for visual symptoms during ivabradine treatment reported by 5% of patients.Conclusions: Our study demonstrates that selective HR reduction with ivabradine is effective and safe in patients with asthma and COPD. Ivabradine offers an interesting alternative in patients with respiratory disease and contraindications to β–blockers.