A randomized controlled trial of ivabradine in patients with acute myocardial infarction related cardiogenic shock.

Autor:	Alcaraz-Guzmán A; Coronary Care Unit, National Institute of Cardiology 'Ignacio Chávez', Mexico City, Mexico. Coronary Care Unit National Institute of Cardiology 'Ignacio Chávez' Mexico City Mexico., Amaro-Palomo EJ; Coronary Care Unit, National Institute of Cardiology 'Ignacio Chávez', Mexico City, Mexico. Coronary Care Unit National Institute of Cardiology 'Ignacio Chávez' Mexico City Mexico., Ruiz-Beltrán AM; Coronary Care Unit, National Institute of Cardiology 'Ignacio Chávez', Mexico City, Mexico. Coronary Care Unit National Institute of Cardiology 'Ignacio Chávez' Mexico City Mexico., Díaz-Herrera BÁ; Coronary Care Unit, National Institute of Cardiology 'Ignacio Chávez', Mexico City, Mexico. Coronary Care Unit National Institute of Cardiology 'Ignacio Chávez' Mexico City Mexico., Neri-Bale RR; Coronary Care Unit, National Institute of Cardiology 'Ignacio Chávez', Mexico City, Mexico. Coronary Care Unit National Institute of Cardiology 'Ignacio Chávez' Mexico City Mexico., Hernández-Bravo L; Coronary Care Unit, National Institute of Cardiology 'Ignacio Chávez', Mexico City, Mexico. Coronary Care Unit National Institute of Cardiology 'Ignacio Chávez' Mexico City Mexico., Candia-Ramírez MA; Coronary Care Unit, National Institute of Cardiology 'Ignacio Chávez', Mexico City, Mexico. Coronary Care Unit National Institute of Cardiology 'Ignacio Chávez' Mexico City Mexico., Gopar-Nieto R; Coronary Care Unit, National Institute of Cardiology 'Ignacio Chávez', Mexico City, Mexico. Coronary Care Unit National Institute of Cardiology 'Ignacio Chávez' Mexico City Mexico., González-Pacheco H; Coronary Care Unit, National Institute of Cardiology 'Ignacio Chávez', Mexico City, Mexico. Coronary Care Unit National Institute of Cardiology 'Ignacio Chávez' Mexico City Mexico., Sierra-Lara Martinez JD; Coronary Care Unit, National Institute of Cardiology 'Ignacio Chávez', Mexico City, Mexico. Coronary Care Unit National Institute of Cardiology 'Ignacio Chávez' Mexico City Mexico., Arias-Mendoza A; Coronary Care Unit, National Institute of Cardiology 'Ignacio Chávez', Mexico City, Mexico. Coronary Care Unit National Institute of Cardiology 'Ignacio Chávez' Mexico City Mexico., Araiza-Garaygordobil D; Coronary Care Unit, National Institute of Cardiology 'Ignacio Chávez', Mexico City, Mexico. Coronary Care Unit National Institute of Cardiology 'Ignacio Chávez' Mexico City Mexico.
Jazyk:	angličtina
Zdroj:	Archivos peruanos de cardiologia y cirugia cardiovascular [Arch Peru Cardiol Cir Cardiovasc] 2024 Jun 24; Vol. 5 (2), pp. e342. Date of Electronic Publication: 2024 Jun 24 (Print Publication: 2024).
DOI:	10.47487/apcyccv.v5i2.342
Abstrakt:	Objective: . Acute myocardial infarction-related cardiogenic shock (AMI-CS) is often accompanied by tachycardia, which, in turn, increases myocardial oxygen consumption and hinders the use of ventricular assist devices, such as intra-aortic balloon pump. Evidence suggests that ivabradine may reduce heart rate (HR) without affecting other hemodynamic parameters. The aim of the present study was to determine the effect of ivabradine on reducing HR and changes in other hemodynamic parameters such as cardiac index (CI), in patients with AMI-CS and tachycardia. Materials and Methods: . A single-center, open label, randomized clinical trial included patients diagnosed with AMI-CS and tachycardia with >100 beats per minute (BPM). Heart rate, cardiac index, and other hemodynamic parameters measured by pulmonary flotation catheter were compared at 0, 6, 12, 24, and 48 hours after randomization. Results: . A total of 12 patients were randomized; 6 received standard therapy, and 6 received ivabradine in addition to standard therapy. Baseline clinical characteristics were similar at randomization. A statistically significant lower heart rate was found at 12 hours (p=0.003) and 48 hours (p=0.029) after randomization, with differences of -23.3 (-8.2 to -38.4) BPM and -12.6 (-0.5 to -25.9) BPM, respectively. No differences in cardiac index, or any other evaluated hemodynamic parameters, length of hospital stay, nor mortality rate were noted between both groups. Conclusions: . The use of ivabradine in patients with AMI-CS was associated with a significant reduction in heart rate at 12 and 48 h, without affecting other hemodynamic parameters. Competing Interests: Conflicts of interest: Alexandra Arias-Mendoza reports having relationships with Pfizer Inc, Novartis, AstraZeneca and Asofarma, which includes fees for talks and conferences. She also reports having a relationship with Novo Nordisk Inc and MSD, including grants for financing. Diego Araiza-Garaygordobil reports having a relationship with Abbott, Asofarma, AstraZeneca, Boehringer Ingelheim, Novartis, Silanes, Servier, Novo Nordisk and Lundbeck, which includes fees for talks and conferences. He also reports having a relationship with Novartis, including funding grants. Rodrigo Gopar-Nieto reports having a relationship with Novartis and Asofarma, which includes fees for talks and conferences. The other authors declare no competing financial interests or known personal relationships that could have influenced the work reported in this article
Databáze:	MEDLINE
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