Comparison of different strategies of ivabradine premedication for heart rate reduction before coronary computed tomography angiography

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dc.authorid0000-0002-6253-3318en_US
dc.contributor.authorCelik, Omer
dc.contributor.authorAtasoy, Mehmet M.
dc.contributor.authorErturk, Mehmet
dc.contributor.authorYalcin, Arif A.
dc.contributor.authorAksu, Hale U.
dc.contributor.authorDiker, Mustafa
dc.contributor.authorAkturk, Faruk I.
dc.contributor.authorErkanli, Korhan
dc.contributor.authorAtasoy, Isil
dc.contributor.authorKiris, Adem
dc.date.accessioned2024-07-12T21:50:18Z
dc.date.available2024-07-12T21:50:18Z
dc.date.issued2014en_US
dc.departmentMaltepe Üniversitesien_US
dc.description.abstractObjective: The aim of this study was to assess the effectiveness and safety of different strategies of ivabradine therapy by comparing the effects on heart rate (HR), blood pressure (BP), and image quality of coronary CT angiography (CTA). Methods: A total of 192 consecutive patients were randomly assigned to 3 groups of oral premedication with ivabradine 15 mg (single dose), 10 mg (single dose), and 5 mg twice daily for 5 days, prospectively. Patients using HR-lowering drugs and patients with beta-blockade contraindication were excluded. The target HR was 65 beats/thin. In addition 5 to 10 mg of intravenous metoprolol was administered to the patients at the CT unit, if required. The systolic and diastolic blood BP values and the HRs were recorded. Image quality was assessed for 8 of 15 coronary segments with a 4-point grading scale. Results were compared with the Kruskal-Wallis test, one-way ANOVA, and chi(2) test. Results: Reductions in mean HR after the treatment were 18 +/- 6, 14 +/- 4, and 17 +/- 7 beats/min for groups 1, 2, and 3, respectively. With the total additional therapies, 81.3%, 67.2%, and 84.3% of the patients achieved HR < 65 beats/min in groups 1, 2, and 3, respectively. The mean BP values before coronary CTA were not significantly changed except for patients in group 2. Unacceptable (score 0) image quality was obtained in only 4.5%, 10.2%, and 4.2% of all the coronary segments, in groups 1, 2, and 3, respectively. Conclusions: Our study indicates that coronary CTA with premedication with oral ivabradine in all 3 strategies is safe and effective in reducing HR, in particular with a beta-blockade combination. All 3 ivabraline regimes may be an alternative strategy for HR lowering in patients undergoing coronary CTA. Ivabradine 15 mg (single dose) and ivabradine 5 mg twice daily for 5 days are superior to the ivabradine 10-mg single-dose regime for HR lowering without adjunctive intravenous beta-blocker usage. (C) 2014 Society of Cardiovascular Computed Tomography. All rights reserved.en_US
dc.identifier.doi10.1016/j.jcct.2013.12.005
dc.identifier.endpage82en_US
dc.identifier.issn1934-5925
dc.identifier.issue1en_US
dc.identifier.pmid24582046en_US
dc.identifier.scopus2-s2.0-84896892910en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage77en_US
dc.identifier.urihttps://dx.doi.org/10.1016/j.jcct.2013.12.005
dc.identifier.urihttps://hdl.handle.net/20.500.12415/8148
dc.identifier.volume8en_US
dc.identifier.wosWOS:000333142400011en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherELSEVIER SCIENCE INCen_US
dc.relation.ispartofJOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHYen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmzKY01819
dc.subjectIvabradineen_US
dc.subjectCoronary CTen_US
dc.subjectSafetyen_US
dc.subjectMultidetector CTen_US
dc.subjectDifferent strategiesen_US
dc.subjectSingle dose versus multiple doseen_US
dc.titleComparison of different strategies of ivabradine premedication for heart rate reduction before coronary computed tomography angiographyen_US
dc.typeArticle
dspace.entity.typePublication

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