Early NT‐proBNP Decrease With Ivabradine in Ambulatory Patients With Systolic Heart Failure. Issue 11 (8th August 2013)

• Record Type: Journal Article
• Authors: Sargento, Luis; Satendra, Milan; Longo, Susana; Lousada, Nuno; Palma dos Reis, Roberto
• Is Part Of: Clinical cardiology. Volume 36:Issue 11(2013:Nov.)
• Page Start: 677
• Page End: 682
• Publication Date: 2013-08-08
• Subjects: Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.22183
• Languages: English
• ISSNs: 0160-9289

Abstract

<abstract abstract-type="main" id="clc22183-abs-0001"> <title>Abstract</title> <sec id="clc22183-sec-0001" sec-type="section"> <title>Background</title> <p id="clc22183-para-0001">Heart rate (HR) reduction in patients with systolic heart failure (HF) is a cornerstone of current therapy. The aim of this study was to evaluate the short‐term effect of the HR reduction with ivabradine on N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) in outpatients with systolic HF.</p> </sec> <sec id="clc22183-sec-0002" sec-type="section"> <title>Hypothesis</title> <p>Ivabradine improves survival and promotes left ventricle remodelling by reducing resting heart rate. Nt‐ProBNP absolute and trends predict prognosis. We hypothesized a possible association between heart rate decrease and Nt‐ProBNP values.</p> </sec> <sec id="clc22183-sec-0003" sec-type="section"> <title>Methods</title> <p id="clc22183-para-0002">We included 25 outpatients with systolic HF on optimized medical therapy (80% on angiotensin‐converting enzyme inhibitors, 56% on spironolactone, and 88% on β‐blocker therapy), left ventricle ejection fraction <40%, and sinus rhythm and HR >70/bpm. After a 1 month running‐out period, to establish the clinical and NT‐proBNP stability, patients were started on ivabradine for 3 months.</p> </sec> <sec id="clc22183-sec-0004" sec-type="section"> <title>Results</title> <p id="clc22183-para-0003">Ivabradine decreased NT‐proBNP (<italic>P</italic> = 0.002) from a median of 2850 pg/mL to 1802 pg/mL, corresponding to a median absolute and percent decrease of 964 pg/mL and 44.5%, respectively. The baseline HR correlated significantly with the baseline NT‐proBNP (<italic>r<sub>s</sub></italic> = 0.411, <italic>P</italic> = 0.041). The absolute and percent HR decrease correlated with the absolute NT‐proBNP decrease (<italic>r<sub>s</sub></italic> = 0.442, <italic>P</italic> = 0.027; <italic>r<sub>s</sub></italic> = 0.395, <italic>P</italic> = 0.05). The greater the NT‐proBNP absolute decrease tertile, the greater the baseline HR (<italic>P</italic> = 0.023) and the absolute (<italic>P</italic> = 0.028) and percent (<italic>P</italic> = 0.064) HR variation.</p> </sec> <sec id="clc22183-sec-0005" sec-type="section"> <title>Conclusions</title> <p id="clc22183-para-0004">In outpatients with systolic HF, the NT‐proBNP reduction obtained by short‐term ivabradine treatment correlates closely with the degree of HR reduction.</p> </sec> </abstract>