Comparison of Ivabradine Versus Metoprolol in Early Phases of Reperfused Anterior Myocardial Infarction With Impaired Left Ventricular Function: Preliminary Findings

Abstract Background β-blockers in ST-segment elevation myocardial infarction (STEMI) are indicated for patients without a contraindication, particularly in patients with high heart rates (HR) or blood pressures. Epidemiological studies have shown that elevated HR represents a risk factor for cardiovascular morbidity. The study investigates the feasibility, tolerability, and the effects after 30 days of follow-up of ivabradine (IVA) versus metoprolol (METO) in early phases of anterior STEMI reperfused by percutaneous coronary intervention (PCI). Methods and Results Patients with a first anterior STEMI, Killip class I-II, an acceptable echocardiographic window, and admitted within 4 hours of the onset of symptoms, with an ejection fraction P P  = .0001). The HR was significantly reduced in both groups, P P  = .0001, with concomitant reduction in ESV and EDV ( P  = .0001, and .048, respectively). The diastolic parameters were similar in both groups during study period. Conclusions Our results suggest that ivabradine may be administered early (12 hours after PCI) to patients with successful PCI for anterior STEMI with an impaired left ventricular function and high HR and sinus rhythm. A larger sample of patients and further studies are required to evaluate the effects of ivabradine on clinical end points.