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To assess the effect of ivabradine on LV function and remodeling in patients with STEMI immafter primary PCI (PPCI).
Fifty seven patients who presented with STEMI within the time window of reperfusion (12hrs) were included in our study. These patients were divided into two groups: Group 1: optimal medical treatment (OMT) including beta-blockers +Ivabradine; Group 2: OMT including beta-blockers without Ivabradine. within 24 hours of PPCI all the patients did baseline echocardiography (LVEF, LVEDD, LVESD) and SPECT (LVEF, LVEDV, LVESV, 17-segment score). After 21 days, echocardiography and SPECT study were repeated.
our patients were predominantly males (84.2%) with mean age of 48.8±10.53 yrs. All the patients underwent PPCI and the most revascularized vessel was LAD (93%). Admission HR was 95.71±12 bpm. Both groups revealed no significant difference after 21 days of treatment apart from significant HR reduction to 68 bpm with Ivabradine (group I) (P<0.001). Subgroup analysis of Group I diabetic patients with HR>100bpm showed significant reduction of echocardiographic LVESD by -4.80±2.09 mm; (P=0.015) and significant improvement of SPECT LVEF to +14.10±7.06 % (P =0.03).
In the setting of STEMI treated with PPCI, Ivabradine significantly reduced the HR. In a subgroup of Diabetic patients with HR > 100bpm, Ivabradine significantly reduced the echocardiographic LVESD and improve the SPECT LVEF.