UNASSIGNED: Eighty patients with AMI were randomly divided into the ivabradine group and the control group. The ivabradine group was treated with ivabradine combined with metoprolol after PCI, while the control group was treated with metoprolol only. Both groups were treated continuously for 1 year. Echocardiography-derived parameters, heart rate, cardiopulmonary exercise testing (CPET) data, major adverse cardiac events (MACE) and myocardial markers were analyzed. The primary endpoint was the left ventricular ejection fraction (LVEF). The safety outcomes were blood pressure, liver and kidney function.
UNASSIGNED: The LVEF was significantly higher in the ivabradine group than in the control group at 1 week, 3 months and 1 year after PCI. The heart rate of the ivabradine group was significantly lower than that of the control group at 1 week and 1month after PCI. The VO2max, metabolic equivalents, anaerobic threshold heart rate, peak heart rate, and heart rate recovery at 8 min of the ivabradine group were significantly higher than those of the control group at 1 year after PCI. Kaplan-Meier analysis demonstrated the one-year total incidence of MACE in the ivabradine group was significantly lower than that in the control group. The B-type natriuretic peptide of the ivabradine group was significantly lower than that of the control group on Day 2 and Day 3 after PCI. The high-sensitivity cardiac troponin I level of the ivabradine group was significantly lower than that of the control group on Day 5 after PCI.
UNASSIGNED: Early use of ivabradine in patients with AMI after PCI can achieve effective heart rate control, reduce myocardial injury, improve cardiac function and exercise tolerance, and may reduce the incidence of major adverse cardiac events. (Clinical research registration number: ChiCTR2000032731).
■80例AMI患者随机分为伊伐布雷定组和对照组。PCI术后伊伐布雷定组采用伊伐布雷定联合美托洛尔治疗,对照组单纯采用美托洛尔治疗。两组均连续治疗1年。超声心动图得出的参数,心率,心肺运动测试(CPET)数据,分析主要不良心脏事件(MACE)和心肌标志物。主要终点是左心室射血分数(LVEF)。安全性结果是血压,肝肾功能。
■在1周时,伊伐布雷定组的LVEF明显高于对照组,PCI术后3个月和1年。PCI术后1周和1个月,伊伐布雷定组心率明显低于对照组。VO2max,代谢当量,无氧阈心率,峰值心率,PCI术后1年,伊伐布雷定组8min心率恢复明显高于对照组。Kaplan-Meier分析显示,伊伐布雷定组一年的MACE总发生率明显低于对照组。PCI术后第2天和第3天,伊伐布雷定组的B型利钠肽明显低于对照组。PCI术后第5天伊伐布雷定组的高敏心肌肌钙蛋白I水平明显低于对照组。
■AMI患者PCI术后早期使用伊伐布雷定可以实现有效的心率控制,减少心肌损伤,改善心脏功能和运动耐量,并可能降低主要不良心脏事件的发生率。(临床研究登记号:ChiCTR2000032731)。