Efficacy of ivabradin to reduce heart rate prior to coronary CT angiography: Comparison with beta-blocker

Ümmügülsüm Bayraktutan, Mecit Kantarci, Fuat Gündoǧdu, Selami Demirelli, Ihsan Yüce, Hayri Oǧul, Cihan Duran, Hakan Taş, Ziya Şimşek, Nevzat Karabulut

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

PURPOSE: The objective of our study was to assess the effect of ivabra-dine on image quality of ECG-gated multidetector computed tomography (MDCT) coronary angiography. MATERIALS AND METHODS: Computed tomography coronary angiography (CTCA) was performed on two groups. In Group 1 (n=54), an intravenous beta-blocker was administered to patients with a heart rate >70 beats per minute (bpm) just before CTCA. In Group 2 (n=56), oral ivabradine 5 mg was administered twice a day for three days prior to CTCA examination to patients with a heart rate >70 bpm and contraindication to beta-blockers. Images acquired on two different MDCT scanners were scored in terms of image quality of the coronary artery segments using a 5-point grading scale (Grade 1, unreadable; Grade 5, excellent). RESULTS: The mean heart rates during CTCA were 64±6.7 bpm for Group 1 and 59±4.1 bpm for Group 2 (P < 0.05). Mean heart rate reduction was 9±5% and 14±8% for Groups 1 and 2, respectively (P < 0.001). A total of 880 segments were evaluated in 110 patients. When the best reconstruction interval was used, 89.8% and 95.5% of all the coronary segments showed acceptable image quality in Groups 1 and 2, respectively. Acceptable image quality of the middle right coronary artery was obtained in 78.3% of Group 1 and 92.4% of Group 2. These ratios for the other segments were 88.4% for Group 1 and 95.2% for Group 2. CONCLUSION: Reduction of heart rates with ivabradine premedication improves the image quality of CTCA. It should be considered as an alternative drug, particularly in patients with contraindications to beta-blockers.

Original languageEnglish (US)
Pages (from-to)537-541
Number of pages5
JournalDiagnostic and Interventional Radiology
Volume18
Issue number6
DOIs
StatePublished - Nov 23 2012
Externally publishedYes

Keywords

  • Coronary angiography
  • Heart rate
  • Ivabradine
  • Multidetector computed tomography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Bayraktutan, Ü., Kantarci, M., Gündoǧdu, F., Demirelli, S., Yüce, I., Oǧul, H., Duran, C., Taş, H., Şimşek, Z., & Karabulut, N. (2012). Efficacy of ivabradin to reduce heart rate prior to coronary CT angiography: Comparison with beta-blocker. Diagnostic and Interventional Radiology, 18(6), 537-541. https://doi.org/10.4261/1305-3825.dir.5981-12.1