Clinical study of the early use of ivabradine in patients with acute myocardial infarction after percutaneous coronary intervention

Abstract Objective To investigate the efficacy of early use of ivabradine in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods 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. Results The echocardiography-derived left ventricular ejection fraction 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 after PCI. The VO2max, metabolic equivalents, anaerobic threshold heart rate, peak heart rate, and heart rate recovery at 8 minutes of the ivabradine group were significantly higher than those of the control group at 1 year after PCI. The one-year total incidence of major adverse cardiac events was 10% in the ivabradine group, which was significantly lower than the 37.5% 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 troponin I level of the ivabradine group was significantly lower than that of the control group on Day 5 after PCI. Conclusion 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 reduce the incidence of major adverse cardiac events.