Journal of Applied Medical Sciences

Ivabradine for the Treatment of Heart Failure: A Systematic Review and Meta-Analysis

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  Abstract

   

  Background: Ivabradine has a pure heart rate reduction. However, the use of ivabradine remains limited due to the conflicting evidence of its safety and efficacy.

  Purpose: To determine the efficacy and safety of ivabradine compared to control in subjects with Heart failure (HF).

  Data Sources: Medline, Embase, Ovid and the Cochrane Central Register of Controlled Trials from inception through June 2018.

  Study Selection: Peer-reviewed, randomized controlled trials of Ivabradine versus control in patients with heart failure with or without low ejection fraction.

  Data Extraction: Two investigators independently extracted data from each eligible study and assessed the risk of bias of included studies.

  Data Synthesis: Six trials with 17886 patients were included. There was no significant difference among Ivabradine treated group versus control in lowering all-cause mortality, cardiovascular mortality or hospital readmission. Ivabradine had an increase in the mean difference in the percentage of ejection fraction (EF) by 3% as compared with control. Bradycardia, phosphenes and blurred vision were significantly higher with ivabradine by 4 and 5 times as compared with control.

  Conclusion: Administration of Ivabradine to adults with HF with or without low EF significantly improved the ejection fraction. However, there was no significant impact on mortality and re-admission rates

   

  Keywords: Ivabradine, heart failure, systematic review, meta-analysis.