Efficacy Of Ivabradine Versus Beta Blockers In Patients With Chronic Heart Failure:A Meta-Analysis

Objective:Aim to evaluate the efficacy of ivabradine versus beta blockers in chronic heart failure patients.Methods:A systematic electronic literature search for randomized controlled studies（RCTs）of ivabradine versus beta blockers in chronic heart failure patients was performed in CNKI、WANFANG、CBM、PubMed,Embase,Cochrane and other databases.The data of heart rate（HR）,6-minwalking test（6MWT）,maximal oxygen uptake（MVO₂）,left ventricular ejection fraction（LVEF）,left ventricular end diastolic diameter（LVEDD）,left ventricular end systolic diameter（LVESD）,brain natriuretic peptide（BNP）were pooled from the RCTs and analyzed by RevMan5.3.Results:A total of 692 chronic heart failure patients（NYHAⅡ-Ⅳ）of5 RCTs were included.Ivabradine is superior to beta blockers in the reduction of HR（MD=-2.17,95%CI=-3.08^-1.26,P<0.001）,the improved of 6MWT（MD=38.73,95%CI=35.01⁴2.45,P<0.001）,the increased of LVEF（MD=1.32,95%CI=0.55².09,P=0.0008）,the reduction of BNP（MD=-62.5,95%CI=-104.20-20.80⁴2.45,P=0.003）,and the increased of MVO₂（MD=2.04,95%CI=0.28³.8,P=0.02）,but showed no statistically significant in LVESD and LVEDD between 2 groups.Conclusion:Ivabradine is superior to beta blockers in short-term clinical efficacy of HR,LVEF,MVO₂,6MWT and BNP for CHF patients.