THE CLINICAL OUTCOME OF IVABRADINE AND NEBIVOLOL IN THE TREATMENT OF STABLE ANGINA PECTORIS PATIENTS WITH MILD LEFT VENTRICULAR DYSFUNCTION

Dr. Mohammad Rashedul Hasan* and Dr. Mahmudul Hasan

ABSTRACT

Background: In chronic stable angina, increased heart rate contributes to the development of symptoms and signs of myocardial ischaemia by increasing myocardial oxygen demand and reducing diastolic perfusion time. Objective: In this study our main goal is to evaluate the clinical outcome of Ivabradine and Nebivolol in the Treatment of Stable Angina Pectoris Patients with Mild Left Ventricular Dysfunction. Methods: This cross-sectional observational study was done at Noakhali 250-Bed General Hospital from April 2020 to December 2020. A total of 200 consecutive patients were included. The patients were evaluated in 2 different groups (1,2). In group-1 Nebivolol 5mg/day was administered to the 100 patients included in Group A. 100 patients were started on Ivabradine 10mg/day and these patients were included into group-2. Result: During the study, according to systolic Diastolic BP and heart rate heart rate decreased (79±7) to (66±5.1) in Group: 1 and (78± 7) to (71 ± 5) in Group: 2. After 6 months’ treatment LVEF for the group-1 improved by (45 ± 6.5) to (52 ± 3.1), and for the group-2 (48± 5.5) to (53 ± 2.1). There is no significant change in EF improvement in both groups. Also, dose-related sinus bradycardia occurred in (5%) of the nebivolol-using patients included in Group-1, where as in group-2 it was 1%. Conclusion: In patients with tachycardia caused angina, Ivabradine can be treated as the first alternative, as this heart rate reducer and chest pain agent. Nebivolol should be treated with the hypertensive tachycardia patient. Better findings are required for further analysis.

Keywords: Coronary heart disease (CHD), Ivabradine, Nebivolol.