New insight on anti-ischemic action of ivabradine in patients with stable angina

Increase in heart rate triggers most ischemic episodes due to disbalance between myocardial oxygen delivery and consumption. Furthermore, increased heart rate is a modifiable risk factor in patients with chronic heart failure. Ivabradine reduces heart rate by selectively inhibiting the If current of sinoatrial node cells. Recent studies have shown that ivabradine may reduce myocardial ischaemia and its consequences not only through heart rate reduction, but also because of additional pleiotropic effects. This review summarizes last findings that demonstrate variety of ivabradine actions on coronary blood flow and left ventricular function in patients with ischemic heart disease.