Hiệu quả giảm nhịp tim của điều trị phối hợp Ivabradine với thuốc chẹn bêta ở bệnh nhân bệnh mạch vành có can thiệp mạch vành qua da

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Tác giả

Nhan đề

Hiệu quả giảm nhịp tim của điều trị phối hợp Ivabradine với thuốc chẹn bêta ở bệnh nhân bệnh mạch vành có can thiệp mạch vành qua da

Nhan đề tiếng anh

Ivabradine in combination with beta blockers effectively reduces the heart rate in patients with coronary atery disease after percutaneous coronary intervention

Nguồn trích

Y dược học Cần Thơ

Năm xuất bản

2018

Số

16

Trang

1-7

ISSN

2345-1210

Từ khóa

Nhịp tim nhanh, Bệnh mạch vành, Ivabradine, Can thiệp mạch vành qua da

Từ khóa tiếng anh

Elevated heart rate, Coronary artery disease, Ivabradine, Percutaneous coronary intervention

Tóm tắt

Phối hợp thuốc Ivabradine với chẹn bêta để kiểm soát nhịp tim ở bệnh nhân bệnh mạch vành là một lựa chọn mới, có nhiều ưu điểm hơn so với tăng liều chẹn bêta và chưa được nghiên cứu rộng rãi trên bệnh nhân có can thiệp mạch vành qua da. Mục tiêu Đánh giá hiệu quả giảm nhịp tim và khảo sát tác dụng phụ của điều trị phối hợp Ivabradine với thuốc chẹn beta ở bệnh nhân bệnh mạch vành có can thiệp mạch vành qua da. Đối tượng và phương pháp nghiên cứu Nghiên cứu tiền cứu không đối chứng được thực hiện trên 70 bệnh nhân bệnh mạch vành có can thiệp mạch vành qua da điều trị tại bệnh viện Đa khoa Trung Ương Cần Thơ từ tháng 8/2016 đến tháng 7/2018. Kết quả nhịp tim trung bình khi nghỉ giảm từ 78,57 ± 9,22 nhịp/phút xuống còn 69,11 ± 7,02 nhịp/phút sau 1 tháng (p<0,001). Hiệu quả làm giảm nhịp tim có ý nghĩa ở nhiều nhóm dân số nghiên cứu, bao gồm người ≥75 tuổi, tăng huyết áp, đái tháo đường type 2, vị trí stent ở động mạch vành phải, động mạch liên thất trước, động mạch mũ. Mức độ giảm nhịp tim ở nhóm có nhịp tim ban đầu ≥80 nhịp/phút cao hơn nhóm <80 nhịp/phút (giảm 13,56 nhịp/phút so với giảm 7,18 nhịp/phút, p<0,001). Thuốc dung nạp tốt ở hầu hết bệnh nhân (98,6%). Tác dụng phụ thường gặp là nhịp chậm xoang không triệu chứng (7,1%), nhịp chậm xoang có triệu chứng (1,4%), lóa mắt (1,4%), ngoại tâm thu thất (1,4%). Kết luận Phối hợp thuốc Ivabradine với chẹn beta liều thấp trong điều trị bệnh mạch vành có can thiệp mạch vành qua da giúp làm giảm nhịp tim hiệu quả và an toàn.

Tóm tắt tiếng anh

Management of heart rate in coronary artery disease patients after percutaneous coronary intervention (PCI) by combination of Ivabradine with beta-blockers provides more potential benefits than uptitration the usual beta-blockers. Objectives Evaluate the heart rate reduction effect and side effects of adding Ivabradine to beta-blockers in patients with coronary artery disease after percutaneous coronary intervention. Materials and method Uncontrolled prospective study was conducted with 70 coronary artery disease inpatients undergone percutaneous coronary intervention in Can Tho Central General Hospital from 08/2016 to 07/2018. ResultsSignificant decrease in mean resting heart rate was found, from 78.57 ± 9.22 bpm at baseline to 69.11 ± 7.02 bpm after 4 weeks (p<0.001). This effect was similar in various analyzed subpopulation, including age ≥75, hypertension, diabetes, left anterior descending, left circumflex artery, right coronary artery stents. The greater magnitude of heart rate reduction was observed in patients with baseline heart rate ≥80 bpm in comparison with heart rate < 80 bpm (-13.56 bpm vs -7.18 bpm, p<0.001). For the safety investigation, 98.6% patients had good tolerability. Common adverse events were non-symptom sinus bradycardia (7.1%), symptomatic bradycardia (1.4%), phosphenes (1.4%), and premature ventricular complex (1.4%). Conclusion Combination of Ivabradine and low dose beta-blockers in patients with coronary artery disease after percutaneous coronary intervention helps reduce heart rate effectively and safely.

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TTKHCNQG, CVv 482

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Tài liệu tham khảo

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