Summary

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• Ivabradine, also known as Corlanor, is indicated to reduce the risk of hospitalization for worsening heart failure in adult patients with stable, symptomatic chronic heart failure with reduced left ventricular ejection fraction. It is also used for treating stable symptomatic heart failure due to dilated cardiomyopathy in pediatric patients ages 6 months and older.
• Seventeen studies provided information about this drug.
• The studies highlight that ivabradine has shown significant efficacy in lowering heart rate and improving left ventricular ejection fraction (LVEF). In some instances, it enhances quality of life and reduces hospitalizations related to heart failures.
• Compared to other drugs such as beta-blockers (e.g., carvedilol), ACE inhibitors, or mineralocorticoid receptor antagonists (MRAs), ivabradine stands out because it selectively inhibits the If channel in the sinoatrial node without significantly altering blood pressure or causing downsides associated with beta-blockade.
• Studies indicate that combinations including ivabradine are among the top treatments for improving outcomes in Heart Failure with Reduced Ejection Fraction (HFrEF).
• Ivabradine seems particularly beneficial where achieving lower rates is crucial but further titration using a beta-blocker isn't possible due to side effects or contraindications. However, its benefits seem less clear for populations like those having NYHA class IV symptoms or Chronic Kidney Disease (CKD) alongside HFrEF.
• For pediatric use: Ivabradine shows efficacy when dealing with children suffering from dilated cardiomyopathy, indicating its safety extends beyond adults, although data specific to children's usage isn't as robust compared to adults.
• Ivabradine alongside SGLT2 inhibitors & ARNIs shows promise in dealing with HFrEF patients who have CKD concurrently, suggesting utility within challenging cohorts where comorbidity complicates management.