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Ivabradine Significantly Decreases hsCRP and Increases the Activity of Glutathione Peroxidase in Patients with Stable Coronary Artery Disease
Jedli?ková L, Merkovská L, Jacková L, Jani?ko M, Feda?ko J, Chmelárová A, and Pella D
Introduction: Ivabradine treatment is considered to be a new approach in the coronary artery disease treatment based on the principle of the heart rate lowering. The aim of this project was to determine whether the heart rate decrease achieved by the ivabradine is accompanied by the improvement of antioxidant activity and reduction of the vascular inflammation, which can lead to the enhancement of the endothelial function.
Patients and methods: There were 30 patients with coronary artery disease in this study. They received treatment with the daily 2x5 mg dose of ivabradine in addition to their long- term treatment. Plasmatic level of hsCRP and activity of glutathione peroxidase was assessed at the beginning of the study and after three months (± one week) of the treatment.
Results: There were 25 (83.3%) men and 5 (16.7%) women in the study. Average age of the patients was 65.4 ± 6.7 years. 28 (93.3%) patients survived myocardial infarction (STEMI or NSTEMI), 23 (76.6%) experienced revascularization (PCI or CABG), 16 (53.3%) patients suffered from diabetes mellitus of the 2. type, 29 (96.6%) patients experienced arterial hypertension. The mean heart rate at the moment of patient’s admission was 77 ± 7 beats in a minute. There was observed a significant increase in the activity of glutathione peroxidase, which increased from 36.31 ± 8.02 U/gHb to 39.96 ± 8.56 U/gHb (p?0.0001). We also observed statistically significant decrease of the hsCRP level, from 4.05 ± 3.28 mg/l to 1.82 ± 1.54 mg/l, p?0.0001.
Conclusion: Not only is the addition of ivabradine to the treatment of patients with coronary artery disease lowering the heart rate, it also positively affects the antioxidant activity and reduces vascular component of inflammation. However, it is necessary to conduct broader clinical, randomized, double-blind, placebo controlled trials to support the findings.