Procoralan (ivabradine)
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NEW DATA SHOW THAT REDUCING HEART RATE REDUCES HEART ATTACK RISK BY UP TO 73% IN PEOPLE WITH ANGINA
01/09/2009
New data presented at the ESC today show that the risk of suffering a heart attack could be reduced by 42% in patients with angina simply by lowering their heart rate with a treatment called Procoralan (ivabradine). People with angina and a resting heart rate ≥70 beats per minute (bpm) were shown to benefit to a greater extent with the addition of ivabradine with a risk reduction of 73%. This reduction in risk was regardless of their current treatment. 1
Ivabradine is the only treatment licensed in the UK to selectively lower heart rate. It is licensed for the symptomatic treatment of chronic stable angina pectoris in patients with normal sinus rhythm who have a contraindication or intolerance for beta-blockers.2
• Angina, a symptom of coronary heart disease (CHD), affects about two million people over the age of thirty-five.3
• Over 1.1 million of these are men and around 850,000 are women.3
• The UK has one of the highest death rates from CHD in Western Europe.4
• Most deaths from heart disease are caused by a heart attack.5
• Every six minutes someone dies of a heart attack in the UK.5
• One in three people who have a heart attack die before reaching hospital.5
Professor Kim Fox, Consultant Cardiologist and lead investigator in the trial commented: “Heart and circulatory disease is the biggest killer in the UK. To stop this, we need to identify new ways to reduce these deaths. The latest findings reinforce that ivabradine may reduce the number of heart attacks in people with angina, especially in those with a faster heart rate. This is very important as previous data show that a faster resting heart rate (≥70 bpm) combined with coronary artery disease (CAD) significantly increases the risk of heart attacks even with standard treatment.”
The data also suggested that by reducing heart rate with ivabradine, there may be a reduction in the need for medical intervention to restore blood flow to the heart in people with a resting heart rate of ≥70 bpm.1
“The data suggest that a reduction in heart rate could prevent heart related disease and deaths in people with stable angina. It consolidates the rationale that measuring heart rate should be routine clinical management in angina patients,” continued Professor Fox.
Numerous studies have confirmed the link between heart rate and prognosis. This is the first time that the benefits of heart rate reduction, a method of reducing symptoms in angina patients, has proven to reduce the risk of heart attack.1
These data demonstrate the benefits of additional heart rate reduction in patients who are already receiving treatment for their angina.1
Data also presented at the ESC have shown that CHD patients, treated in the UK in primary care, receive sub-optimal doses of beta-blockers, a first-line treatment for stable angina. Almost 60% of patients with CHD (diagnosis of angina, heart failure or previous heart attack) were on less than 50% of the target dose recommended by the ESC guidelines (evidence based doses).6 Around a third of angina patients had discontinued beta-blocker therapy within 1 year of initiation, rising to more than a half of patients at 3 years.7
The measurement and monitoring of heart rate in patients with stable angina, could not only help in assessing a patient’s risk of experiencing a heart attack, but also guide the physician to the appropriate treatment to reduce a patient’s risk of angina symptoms or a heart attack.
- ENDS -
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NOTES TO EDITORS
About the BEAUTIFUL study1, 7, 8, 9
• BEAUTIFUL (morBidity-mortality EvAlUaTion of the If inhibitor ivabradine in patients with coronary heart disease and left ventricULar dysfunction) study was a randomised, double-blind, placebo-controlled study involving 10,917 people in 33 countries and included 24 trial centres across the UK. The study set out to evaluate whether mortality and morbidity would be reduced by the addition of the selective heart rate-lowering treatment, ivabradine, to current therapy in patients with stable CAD and LV systolic dysfunction.7 On entering the trial 87% of patients were receiving treatment with beta-blockers, 89% with renin-angiotensin system agents, 94% were receiving antithrombotic agents, 76% lipid lowering agents, 12% calcium channel blockers. 37% of patients also had diabetes and 40% had metabolic syndrome.8
• The study found that patients with a resting heart rate of ≥70bpm were at significantly greater risk of heart problems.9 In this group, treatment with ivabradine was associated with significant reductions in heart attacks. Treatment with ivabradine showed no effect on hospitalisation for heart failure or CV death which were individual components of the primary endpoint.7
About Procoralan4
• Ivabradine (Procoralan®) is a novel selective heart-rate lowering agent that reduces heart rate without affecting myocardial contractility. It is an anti-ischaemic agent that is licensed for the symptomatic treatment of chronic stable angina pectoris in patients with normal sinus rhythm who have a contraindication or intolerance for beta-blockers.4
About angina
• Angina is chest pain or discomfort, which occurs when the heart is not getting enough oxygen due to reduced blood flow to the heart. It affects about two million people over thirty-five, over 1.1 million of these are men and around 850,000 are women.2 The UK has one of the highest death rates from CHD in Western Europe.3
• Elevated resting heart rate (≥70 bpm) combined with CAD significantly increases the risk of heart attacks9 and angina attacks even with standard treatment.10
About Servier Laboratories Limited
• Servier Laboratories Limited is the UK subsidiary of The Servier Research Group, a research-based pharmaceutical company specialising in innovative pharmaceuticals. Servier UK offers a range of products in a number of medical areas: cardiovascular disease, especially hypertension and cardiac disease, diabetes, osteoporosis and diseases of the central nervous system. Servier develops truly innovative drugs and invests in therapeutic areas where there is an unmet patient need.
References
1. Fox K et al. Eur Heart J Online September 2009
2. PROCORALAN Summary of Product Characteristics. http://emc.medicines.org.uk
3. British Heart Foundation. Prevalence of angina. www.heartstats.org/datapage.asp?id=1122. (Last accessed 30.07.09)
4. British Heart Foundation. Mortality. www.heartstats.org/datapage.asp?id=17 (Last accessed 30.07.09)
5. British Heart Foundation. Heart Facts. www.bhf.org.uk/news_and_campaigning/press_office/media_toolkit/heart_disease_stats/heart_facts.aspx (Last accessed 12.08.09)
6. Setakis E et al. ESC 2009. Abstract 84178
7. Setakis E et al. ESC 2009. Abstract 84186
8. Fox K et al. Lancet 2008; 372: 807-816
9. Fox K et al. Am Heart J 2006; 152: 860-866
10. Fox K et al. Lancet 2008; 372: 817-821
11. Andrews TC et al. Circulation 1993; 88: 92-100
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