Administration of ivabradine in computerized tomography (CT) of coronary artery:a Meta-analysis

Fei Shuyang; Xing Na; Qiu Yigang; Li Jing; Huang Yixiong; Zhang Rong; Fei Yuxing

doi:10.3969/j.issn.1674-4055.2018.02.08

Abstract：Objective To review the effect of ivabradine on heart rate (HR) controlling during computerized tomography (CT) of coronary artery by applying Meta-analysis. Methods The databases of PubMed, CENTRAL, EMbase, CBM, CNKI and WanFang Database were retrieved, and eligible randomized controlled trials (RCT) were given Meta-analysis after quality reviewing and data extracting. Results There were 8 RCT included involved 1298 cases, and 765 in intervention group and 533 in control group. The results showed that HR was significantly decreased in intervention group (MD=-8.92, 95%CI: -10.24~ -7.59, P<0.0001) compared with control group, and the effect of decreasing HR was more significant in intervention group than that in β-receptor blocker group (MD=-5.16, 95%CI: -8.54~ -1.78, P=0.003). There was no significant difference between 10 mg ivabradine and 15 mg ivabradine in decreasing HR (MD=4.87, 95%CI: -5.81~15.55, P=0.37). The systolic blood pressure was slightly elevated in intervention group compared with that in control group, and diastolic blood pressure was slightly elevated in intervention group compared with β-receptor blocker group. The percentage of achieving target HR was higher in intervention group than that in blank control group (MD=3.78, 95%CI: 2.79~5.13, P<0.0001), and the difference was not significant between intervention group and β-receptor blocker group. The adverse reactions were mainly transient nodal bradyarrhythmia, photopsy, blurred vision and photopsia. There were no severe life-threatening adverse reactions observed. Conclusion During CT of coronary artery, ivabradine (10 mg~15 mg) can be used to replace β-receptor blocker and/or non-dihydropyridines calcium channel blocker for controlling HR.