Ivabradine works well to lower heart rate and enhance therapeutic outcomes in chronic heart failure patients with low ejection fraction (HFrEF). However, only the short-acting ivabradine formulation, which needs to be taken twice daily, is now available. For a study, researchers sought to assess the effectiveness of ivabradine hemisulfate sustained release (SR), a brand-new, once-daily long-acting formulation of ivabradine.

Patients with stable HFrEF in functional classes II-IV of the New York Heart Association were included, and they were randomly assigned to receive either a placebo or ivabradine SR in addition to their usual meds. The change in left ventricular (LV) end-systolic volume index between baseline and week 32 served as the main outcome.

They randomly allocated 179 patients to receive ivabradine SR and 181 participants to receive a placebo. After 32 weeks, both arms showed a statistically significant improvement in LV end-systolic volume index compared to baseline. However, the ivabradine SR arm showed a higher impact. When compared to placebo, ivabradine SR medication outperformed it in terms of LV end-diastolic volume index, LV ejection fraction, resting heart rate, Kansas City Cardiomyopathy Questionnaire score, and hospital admission for worsening heart failure and cardiovascular disease. Overall, there was no difference between the treatment groups in adverse events. In the ivabradine SR arm, fewer instances of heart failure became worse.

The study showed that individuals with HFrEF who received ivabradine SR once daily in addition to the best conventional medication had improved heart function.

Reference: jacc.org/doi/10.1016/j.jacc.2022.05.027