Ivabradine is a specific heart rate-lowering antianginal agent that was evaluated
in a clinical development program involving approximately 3,000 patients with stable
coronary artery disease, most with angina pectoris. We analyzed the pharmacokinetics,
efficacy (evaluated by exercise tolerance testing), safety, and effects on glucose
metabolism of ivabradine in patients with diabetes mellitus (DM) in this program.
Most analyses included data from 535 patients with DM, approximately 18% of the overall
patient sample. Patients with DM were older, more likely to be women, and more likely
to have more severe angina pectoris than patients without DM. The pharmacokinetics
of ivabradine did not differ in patients with DM versus those without DM. A reduction
in the heart rate at rest with ivabradine was similar in those with (15.2%) and without
(15.7%) DM. At baseline, the exercise capacity tended to be lower in the patients
with DM, but the improvements in most exercise tolerance measures with ivabradine
treatment were similar in patients with and without DM. No special safety concerns
were associated with ivabradine in those with DM. The rates of sinus bradycardia and
visual disturbances, known to be related to the action of ivabradine, showed no relative
increase in the patients with DM. Ivabradine treatment was not associated with adverse
effects on glucose metabolism. In conclusion, ivabradine was effective in preventing
angina in patients with DM and was not associated with particular safety concerns
or adverse effects on glucose metabolism. Ivabradine represents an attractive alternative
to β blockers in patients with stable angina pectoris and DM.
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Article info
Publication history
Published online: November 09, 2009
Accepted:
August 7,
2009
Received in revised form:
August 7,
2009
Received:
May 4,
2009
Footnotes
This study was supported by Servier, Neuilly-sur-Seine, France; Drs. Borer and Tardif are paid consultants to Servier.
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
