Use of Ivabradine in Patients with Cardiorespiratory Pathology

Chronic obstructive pulmonary disease (COPD) remains a critical medical and social challenge due to its high prevalence, significant impact on work incapacity, and its role as a leading cause of mortality. This is further complicated by frequent comorbidities such as coronary heart disease (CHD) and metabolic syndrome (MS), which exacerbate cardiovascular risks and hinder effective management. This study aimed to evaluate the efficacy of ivabradine in preventing cardiovascular complications in patients with COPD combined with CHD and MS.

The study included 114 patients: 76 with COPD and CHD (Group I) and 38 with COPD and MS (Group II). Ivabradine was administered at 5 mg twice daily, and outcomes were assessed after three months. Clinical and instrumental evaluations revealed significant improvements in both groups, including reduced frequency of angina attacks, decreased nitrate use, and improved heart rate regulation. Holter monitoring demonstrated a reduction in painless myocardial ischemia duration by 47.6% in Group I and 54.3% in Group II (p < 0.05).

Patients exhibited improved oxygenation (increased PaO2 and decreased PaCO2), enhanced exercise tolerance, and reduced pulmonary artery pressure. Importantly, ivabradine showed no adverse effects on bronchial patency. These findings underscore the efficacy of ivabradine in optimizing hemodynamic parameters, improving exercise capacity, and preventing cardiovascular complications in COPD patients with comorbid conditions.

Conclusion: Ivabradine at 5 mg twice daily is a promising antianginal treatment for patients with COPD and cardiorespiratory pathologies, effectively reducing angina frequency, improving lung function, and mitigating cardiovascular risks without compromising bronchial health.