Heart rate reduction with ivabradine according to β-blockers and heart rate category

The impact of ivabradine on heart rate reduction is not dependent on the dosage of β-blocker but instead on baseline heart rate.1

BB category
(% of target dose)
Placebo event
rate (%)
Hazard
ratio
95 % CI P
heterogeneity
P
Trend
P Trend
adj*
Primary end point (cardiovascular death or hospitalization for worsening heart failure)
No β-blocker 39.3 0.71 0.55-0.93 0.35 0.056 0.135
BB, 25% 40 0.74 0.59-0.92
BB, 25% to <50% 30.8 0.81 0.68-0.98
BB, 50% to <100% 24.8 0.88 0.72-1.07
BB, ≥100% 20.1 0.99 0.79-1.24
Heart Failure hospitalization
No β-blocker 29 0.62 0.45-0.85 0.55 0.12 0.19
BB, 25% 29 0.68 0.52-0.89
BB, 25% to <50% 22 0.74 0.59-0.93
BB, 50% to <100% 18 0.83 0.65-1.05
BB, ≥100% 14 0.84 0.63-1.11

1. Swedberg K, et al. J Am Coll Cardiol. 2012;59(22):1938-1945.

The magnitude of the ivabradine-associated reduction in CV death or hospitalization for worsening heart failure (primary end point) and other outcomes was similar in patients with and without mineralocorticoid receptor antagonists.1


1. Komajda M, et al. Eur J Heart Fail. 2013;15(1):79-84.