PMID- 27312076
OWN - NLM
STAT- MEDLINE
DCOM- 20170117
LR  - 20181202
IS  - 1179-1918 (Electronic)
IS  - 1173-2563 (Linking)
VI  - 36
IP  - 10
DP  - 2016 Oct
TI  - Ivabradine in Patients with ST-Elevation Myocardial Infarction Complicated by 
      Cardiogenic Shock: A Preliminary Randomized Prospective Study.
PG  - 849-56
LID - 10.1007/s40261-016-0424-9 [doi]
AB  - BACKGROUND AND OBJECTIVE: An elevated heart rate (HR) is an independent risk 
      factor for mortality and morbidity in patients with acute heart failure (HF). The 
      purpose of this study was to evaluate the impact of ivabradine, a selective 
      HR-lowering agent, in patients with cardiogenic shock (CS) complicating 
      ST-elevation acute myocardial infarction (AMI). METHODS: Patients with post-AMI 
      CS were randomized to standard treatment (SDT, 28 patients) or to standard 
      treatment plus ivabradine (I + SDT, 30 patients). In the presence of orotracheal 
      intubation (OTI), ivabradine was administered by nasogastric intubation. HR, BP, 
      New York Heart Association (NYHA) class, NT-proBNP, left ventricular ejection 
      fraction (LVEF) and diastolic function (LVDF) were monitored at specific times 
      after the onset of AMI. The primary (surrogate) end-point was the in-hospital 
      halving of plasma NT-proBNP levels. The secondary end-points were cardiovascular 
      death, hospital re-admission for worsening HF, and clinical and haemodynamic 
      improvement. RESULTS: Treatment groups were statistically similar with regard to 
      age, gender distribution, cardiovascular risk factors, number of diseased vessels 
      and overall treated lesions, AMI site and occurrence of OTI. In-hospital 
      mortality was double in the SDT group in comparison with the I + SDT group (14.3 
      vs. 6.7 %), but the difference was not statistically significant. HR, BP, 
      NT-proBNP and LVEF favorably changed in both groups, but the change was more 
      relevant in the I + SDT group. LVDF significantly changed only in the I + SDT 
      group (p < 0.01). Patients in the I + SDT group did not experience adverse 
      effects. CONCLUSION: Ivabradine in CS complicating AMI is safe, is associated 
      with a short-term favourable outcome and can be effectively administered by 
      nasogastric intubation.
FAU - Barilla, Francesco
AU  - Barilla F
AD  - Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and 
      Geriatric Sciences, Sapienza University of Rome, Rome, Italy. 
      francesco.barilla@uniroma1.it.
AD  - Cardiac Intensive Care Unit "B", Dipartimento Cuore e Grossi Vasi "Attilio 
      Reale", Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, 
      Italy. francesco.barilla@uniroma1.it.
FAU - Pannarale, Giuseppe
AU  - Pannarale G
AD  - Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and 
      Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
FAU - Torromeo, Concetta
AU  - Torromeo C
AD  - Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and 
      Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
FAU - Paravati, Vincenzo
AU  - Paravati V
AD  - Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and 
      Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
FAU - Acconcia, Maria Cristina
AU  - Acconcia MC
AD  - Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and 
      Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
FAU - Tanzilli, Gaetano
AU  - Tanzilli G
AD  - Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and 
      Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
FAU - Mangieri, Enrico
AU  - Mangieri E
AD  - Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and 
      Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
FAU - Dominici, Tania
AU  - Dominici T
AD  - Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and 
      Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
FAU - Martino, Francesco
AU  - Martino F
AD  - Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, 
      Rome, Italy.
FAU - Pannitteri, Gaetano
AU  - Pannitteri G
AD  - Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and 
      Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
FAU - Gaudio, Carlo
AU  - Gaudio C
AD  - Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and 
      Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - New Zealand
TA  - Clin Drug Investig
JT  - Clinical drug investigation
JID - 9504817
RN  - 0 (Benzazepines)
RN  - 0 (Cardiovascular Agents)
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 3H48L0LPZQ (Ivabradine)
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Aged
MH  - Benzazepines/*therapeutic use
MH  - Cardiovascular Agents/*therapeutic use
MH  - Female
MH  - Heart Failure/drug therapy
MH  - Humans
MH  - Ivabradine
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/blood
MH  - Peptide Fragments/blood
MH  - Prospective Studies
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/*drug therapy
MH  - Shock, Cardiogenic/*complications
MH  - Ventricular Function, Left/drug effects
EDAT- 2016/06/18 06:00
MHDA- 2017/01/18 06:00
CRDT- 2016/06/18 06:00
PHST- 2016/06/18 06:00 [entrez]
PHST- 2016/06/18 06:00 [pubmed]
PHST- 2017/01/18 06:00 [medline]
AID - 10.1007/s40261-016-0424-9 [pii]
AID - 10.1007/s40261-016-0424-9 [doi]
PST - ppublish
SO  - Clin Drug Investig. 2016 Oct;36(10):849-56. doi: 10.1007/s40261-016-0424-9.