Abstract 20934: Ivabradine Is Safe and Efficient for the Treatment of Stable Angina Pectoris in Octogenarians
Bibliographic record
Abstract
Objectives: The REDUCTION multicentre study evaluated the efficacy and safety of ivabradine in stable angina in routine clinical practice. In patients over 80 years (octogenarians) there is an increased incidence of bradycardia due to age-related alteration of the sinus node, AV node and of the conduction system. In this subgroup analysis, the efficacy and safety of ivabradine was evaluated in octogenarians. Methods: 382 octogenarians with chronic stable angina pectoris were followed for a mean of 4 months. Patients were treated with ivabradine twice daily (bid) in flexible doses (2.5, 5 or 7.5 mg bid). After baseline evaluation two consecutive visits were conducted after 1 and 4 months. At each visit doses could be increased to further reduce heart rate. Heart rate (HR) during rest, the number of angina attacks, nitrate consumption, overall efficacy and tolerance according to the physicians judgement were evaluated. Results: 382 octogenarians (intention to treat, mean age 83 ± 2.9 years, 42.3% male) with chronic stable angina pectoris were analyzed. 45% of the patients had undergone a PCI or CABG before and 35% had a myocardial infarction in their history. Almost all patients received concomitant standard medication. At baseline, mean HR was 82.8 ± 15.5 bpm and 81% of patients had at least one angina attack per week. Overall a mean of 3.0 ± 4.6 angina attacks per week were reported and consumption of short-acting nitrates was 4.2 ± 5.1 units per week. After 4 months of treatment, ivabradine reduced HR by 11.9 ± 12 bpm in a mean dose of 9.4 mg per day. The number of angina attacks was reduced by 73% and nitrate consumption by 74%, respectively. Four pts (1.0%) reported suspected adverse drug reactions (ADR). In one patient a syncope occured. The patient completely recovered. There was no symptomatic bradycardia reported. For 95% of patients physicians considered the efficacy of ivabradine as “very good/good”. For 99% of patients the tolerance was rated as “very good/good”. Conclusions: The results demonstrate the efficacy of ivabradine in reducing heart rate, number of angina attacks and nitrate consumption in octogenarian patients. The treatment of angina pectoris with ivabradine was effective, safe and was very well tolerated without relevant bradycardia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".