Efficacy And Safety Of Ivabradine For Patients With Acute Heart Failure:Meta-analysis Of Randomized Controlled Trials

Objective:Aim to systematically evaluate the efficacy and safety of Ivabradine in Acute heart failure(AHF).Method:We search the papers from the databases including Pubmed、Embase、Cochrane Library、CNKI、WANFANG DATA、VIP Database、CBM and other databases to collect the Randomized controlled trials(RCTS)of ivabradine in acute heart failure from inception to December 2021.We used Review Manager version 5.3software to perform the meta-analysis.Results:A total of 13 publications(9 trials)were finally enrolled in this artical,with 613 patients(299 in IVA group and 314 in general treatment group).Meta-analys displayed that,to compared with the general treatment group,IVA group had significantly decreased heart rate(WMD=-7.39,95%CI(-9.85,-4.92),P<0.00001),BNP(SMD=-0.56,95%CI(-0.94,0.19),P=0.03)and NT-pro BNP(WMD=-1061.52,95%CI(-1516.54,-606.50),P<0.00001).Left ventricular ejection fraction(LVEF)(WMD=2.44,95%CI(0.77,4.11),P=0.004),6-minute walk distance(WMD=17.21,95%CI(2.04,32.38),P=0.03)were significantly increased.All the indicators above showed statistical differences,while all-cause mortality,cardiogenic mortality,the events of readmission and major adverse cardiovascular were not statistically different between 2 groups.Conclusion: The efficacy of ivabradine in acute heart failure is obviously.It can reduce the heart rate,BNP and NT-pro BNP,and elevate LVEF and 6MWD significantly.It also has a stable safety profile,with similar risks of all-cause mortality,cardiogenic mortality,the incidence of readmission and major adverse cardiovascular compared with the control group.Thus,ivabradine can be used in patients with acute heart failure to improve cardiac function,synergized with adrenergic beta blockers.However,limited to the quality and quantity of the included literatures,more superb studies are needed to validate these findings in the future.