Ivabradine: a guide to its use in chronic heart failure

Oral ivabradine (Procoralan ® ; Coralan ® ) is a useful option for the treatment of patients with symptomatic chronic heart failure with systolic dysfunction. It is the only specific I f current inhibitor approved for use in chronic heart failure and in the treatment of coronary artery disease, and is available in various countries worldwide, including the EU and Australia. Ivabradine is a pure heart rate-lowering drug, without other direct cardiovascular effects. In the randomized, double-blind, placebo-controlled, multinational SHIFT trial, the risk of cardiovascular death or hospital admission for heart failure was significantly reduced by ivabradine; this was mainly driven by the reduction in heart failure hospitalizations. Beneficial effects were seen for various other outcomes, including the risk of death because of heart failure. Ivabradine was generally well tolerated, with bradycardia being one of the most commonly reported adverse events.