Effects of Ivabradine on Neopterin and NT-Pro BNP in Patients with Congestive Heart Failure

Abstract

Abstract Background: Heart rate (HR) reduction is a cornerstone in heart failure (HF) therapy to improve 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: A double blinded, parallel interventional study including sixty patients randomly allocated into ivabradine (5 mg twice daily) or non-ivabradine group (n=30, each) 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 both groups after intervention (p < 0.001), with a greater improvement in ivabradine group (p=0.026). Heart rate was reduced in both groups (p < 0.001) with greater reduction in ivabradine group (p < 0.001). NT-Pro BNP and neopterin levels significantly decreased in ivabradine group (p < 0.001). Significant positive correlation was found between HR and biomarkers levels after intervention (NT-Pro BNP: p < 0.001, neopterin: p=0.002). Conclusion: Ivabradine therapy reduced levels of both biomarkers which correlated well with HR. Biomarkers levels might provide a tool for assessing ivabradine effectiveness in HF.