Clinical comparative study assessing the effect of ivabradine on neopterin and NT-Pro BNP against standard treatment in chronic heart failure patients

Gaidaa M Dogheim, Ibtsam Khairat, Gamal A Omran, Sahar M El-Haggar, Ahmed M El Amrawy, Rehab H Werida, Gaidaa M Dogheim, Ibtsam Khairat, Gamal A Omran, Sahar M El-Haggar, Ahmed M El Amrawy, Rehab H Werida

Abstract

Purpose: Heart rate reduction (HR) is a cornerstone in heart failure therapy as it improves patient outcomes. The aim of this study is to evaluate short-term effect of ivabradine on NT-Pro BNP and neopterin in heart failure patients and assess the association between HR and these biomarkers.

Methods: Sixty patients on standard heart failure therapy were randomly allocated into ivabradine group (n = 30) and non-ivabradine group (n = 30). Ivabradine 5 mg twice daily was given for 3 months. Lipid profile and kidney functions were performed and blood samples for NT-Pro BNP and neopterin were analysed at baseline and after 3 months of intervention in both groups.

Results: There was a significant improvement in NYHA class in ivabradine group (p < 0.001). Ejection fraction was improved in ivabradine and non-ivabradine groups after intervention (p < 0.001), with a greater improvement in ivabradine group (p = 0.026). Heart rate was reduced in ivabradine group (p < 0.001) and non-ivabradine group (p < 0.001) yet greater reduction was seen in ivabradine group (p < 0.001). Serum creatinine and blood urea nitrogen were reduced in ivabradine group (Scr: p = 0.001, BUN: p = 0.001). NT-Pro BNP and neopterin levels significantly decreased in ivabradine group (NT-Pro BNP: p < 0.001, neopterin p < 0.001). Significant positive correlation was found between HR and biomarker levels after intervention (NT-Pro BNP: r = 0.475, p < 0.001, neopterin: r = 0.384, p = 0.002).

Conclusion: Ivabradine therapy reduced levels of both biomarkers which correlated well with HR. Biomarker levels might provide a tool for assessing ivabradine effectiveness in HF. Trial registration Date: June 26, 2020. Identifier: NCT04448899. Link: Ivabradine in Patients with Congestive Heart Failure-Full Text View-ClinicalTrials.gov.

Keywords: Heart failure; Ivabradine; N-Terminal-pro BNP; Natriuretic peptide; Neopterin.

Conflict of interest statement

The authors declare no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Consort flow diagram for participants’ screening, randomisation, allocation and follow-up
Fig. 2
Fig. 2
Change in NT-Pro-BNP and neopterin levels after intervention in the studied groups. NT-Pro BNP: N-terminal-pro brain natriuretic peptide. Statistically significant at p < 0.05
Fig. 3
Fig. 3
Pearson correlation of NT-Pro-BNP with neopterin in the studied groups before and after intervention. NT-Pro BNP: N-terminal-pro brain natriuretic peptide. Statistically significant at p < 0.05
Fig. 4
Fig. 4
Area under ROC curve of both biomarkers of the studied groups. NT-Pro BNP: N-terminal-pro brain natriuretic peptide; Follow, follow-up

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