The Effect of Ivabradine on Hospitalization of Heart Failure Patients: A Retrospective Cohort Study

Sara Al-Balushi; Mohammed Fasihul Alam; Abdul Rehman Abid; Amal Sharfi

doi:10.4103/HEARTVIEWS.HEARTVIEWS_23_20

The Effect of Ivabradine on Hospitalization of Heart Failure Patients: A Retrospective Cohort Study

Heart Views. 2021 Jul-Sep;22(3):165-173. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_23_20. Epub 2021 Oct 11.

Authors

Sara Al-Balushi¹, Mohammed Fasihul Alam², Abdul Rehman Abid¹, Amal Sharfi¹

Affiliations

¹ Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
² Department of Public Health, College of Health Sciences, Health Cluster, Qatar University, Doha, Qatar.

PMID: 34760047
PMCID: PMC8574096
DOI: 10.4103/HEARTVIEWS.HEARTVIEWS_23_20

Abstract

Background: Ivabradine is recommended in heart failure (HF) patients to reduce cardiovascular death and hospitalization due to worsening of HF symptoms.

Aims and objectives: To study the effect of Ivabradine in addition to guideline-directed medical therapy (GDMT) in a group of HF patients with HR more than 70 bpm, HF with reduced ejection fraction (HFrEF) left ventricular ejection fraction (LVEF ≤ 40%), and New York Heart Association class II-IV.

Methods: The study was conducted at Heart Hospital, Hamad Medical Corporation, Qatar. HF patients with age > 18 years, LVEF ≤40%, on GDMT, and HR of ≥70 bpm were included. The study population was divided into two groups: ivabradine group and non-ivabradine group. The primary outcomes were risk, number and length of hospitalizations due to worsening HF, and cardiovascular mortality. The secondary outcome was all-cause mortality. Baseline characteristics were collected at enrollment. Study outcomes were compared in the two groups by applying Chi-square and Fisher's exact tests. Logistic regression model was applied to assess both hospitalizations and cardiovascular mortality.

Results: A total of 111 patients were studied, 37 (33.94%) ivabradine group and 74 (66.67%) non-ivabradine group. Risk of hospitalization was lower in Ivabradine group compared to non-Ivabradine group (odds ratio: 0.43, 95% confidence interval [CI]: 0.16-1.015, P = 0.094). Average length of hospitalization in ivabradine and non-ivabradine groups was 12.54 and 8.91 days, respectively (incidence rate ratio [IRR]: 1.63, 95% CI: 0.79-3.38, P = 0.187). Compared to non-ivabradine, ivabradine patients had lower number of hospitalizations (IRR: 1.13, 95% CI: 0.61-2.11, P = 0.694). Death rate in both ivabradine and non-ivabradine groups was 3.

Conclusions: Ivabradine along with GDMT reduces the risk of hospitalization due to worsening HF symptoms. Ivabradine had no significant effect on cardiovascular mortality and all-cause mortality. HFrEF non-Arabs patients have lower risk, number and length of hospitalization, and mortality compared to Arabs.

Keywords: Cardiovascular disease; heart failure; hospitalization; ivabradine.