Ишемическая болезнь сердца на данный момент является не только тяжелым в клиническом плане заболеванием, требующим, как правило, мультидисциплинарного подхода, но и важной социальной и экономической проблемой. Контроль частоты сердечных сокращений – один из основных терапевтических принципов, который необходимо соблюдать у больных с ишемической болезнью сердца. В практической деятельности нередки случаи, когда существуют противопоказания к назначению b-адреноблокаторов для снижения частоты сердечных сокращений у таких больных (например, нарушения углеводного или липидного обменов). Альтернативой может служить препарат ивабрадин – If-ингибитор ионных потоков избирательного действия, характеризующийся отрицательным хронотропным действием и не оказывающий отрицательного инотропного действия, а также не влияющий на атриовентрикулярную проводимость и артериальное давление. Терапия ивабрадином, как правило, хорошо переносится, что увеличивает приверженность пациентов лечению. Одним из качественных генериков ивабрадина является препарат Раеном® («Гедеон Рихтер», Венгрия).
Ischemic heart disease is not only serious disorder with special clinical characteristics and generally requiring multidisciplinary approach, but also a social and economic problem now. Heart rate control is one of the main therapeutic principles that should be applied in patients with ischemic heart disease. In practice there are always cases when b-blockers for reducing heart rate should not be used because of contraindications in patients (for example, disorders of carbohydrate and lipid metabolism). Ivabradine can be an alternative in this situation due to selective and specific inhibition of the If-channels current across the cardiac pacemaker, characterized by negative chronotropism without negative inotropic effect and without affecting atrioventricular conduction and blood pressure. Ivabradine therapy is generally well tolerated and increases adherence commitment of patients to treatment. Raenom® (Gedeon Richter, Hungary) is generic ivabradine of good-quality.
1. Российский статистический ежегодник-2014, Федеральная служба государственной статистики. электронный ресурс: www.gks.ru / Rossiyskiy statisticheskiy ezhegodnik-2014, Federal'naya sluzhba gosudarstvennoy statistiki. elektronnyy resurs: www.gks.ru [in Russian]
2. ESC guidelines on the management of stable coronary artery disease, 2013. Eur Heart J 2013; 34: 2949–3003.
3. Диагностика и лечение хронической ишемической болезни сердца. Клинические рекомендации МЗ РФ, 2013 г. http://cardioweb.ru/klinicheskie-rekomendatsii. / Diagnostika i lechenie khronicheskoy ishemicheskoy bolezni serdtsa. Klinicheskie rekomendatsii MZ RF, 2013 g. http://cardioweb.ru/klinicheskie-rekomendatsii. [in Russian]
4. ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2012; 60: e44–164.
5. Copie X, Hnatkova K, Staunton A et al. Predictive power of increased heart rate versus depressed left ventricular ejection fraction and heart rate variability for risk stratification after myocardial infarction. Results of a two-year follow-up study. J Am Coll Cardiol 1996; 27 (2): 270–6.
6. Diaz A, Bourassa MG, Guertin M-C, Tardif J-C. Long-term prognostic value of resting heart rate in patients with suspected or proven coronary artery disease. Eur Heart J 2005; 26 (10): 967–74.
7. Pocock SJ, Wang D, Pfeffer MA et al. Predictors of mortality and morbidity in patients with chronic heart failure. Eur Heart J 2006; 27 (1): 65–75.
8. Gillum RF, Makuc DM, Feldman JJ. Pulse rate, coronary heart disease, and death: the NHANES I Epidemiologic Follow-up Study. Am Heart J 1991; 121 (1): 172–7.
9. Castelli WP, Levy D, Wilson PWF, Kannel W. Sudden death: The view from Framingham. The Prevention of Sudden Death. Ed. by JB Kostis, M Sanders. New York: E Wiley-Liss, 1990; p. 1–8.
10. Janssen I, Katzmarzyk PT, Church TS, Blair SN. The Cooper Clinic Mortality Risk Index: clinical score sheet for men. Am J Prev Med 2005; 29 (3): 194–203.
11. Ерофеева С.Б., Манешина О.А. Место ивабрадина – первого If-ингибитора избирательного и специфического действия, в лечении сердечно-сосудистых заболевнаий. Качественная клиническая практика. 2006; 1: 10–22. / Erofeeva S.B., Maneshina O.A. Mesto ivabradina – pervogo If-ingibitora izbiratel'nogo i spetsificheskogo deystviya, v lechenii serdechno-sosudistykh zabolevnaiy. Kachestvennaya klinicheskaya praktika. 2006; 1: 10–22. [in Russian]
12. Fox K, Ford I, Steg PG et al. Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebo-controlled trial. Lancet 2008; 372 (9641): 807–16.
13. Swedberg K, Komajda M, Bohm M et al. Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet 2010; 376 (9744): 875–85.
14. Riccioni G. Ivabradine: recent and potential applications in clinical practice. Exp Opin Pharmacother 2011; 12 (3): 443–50.
15. Ulu N, Henning RH, Goris M et al. Effects of ivabradine and metoprolol on cardiac angiogenesis and endothelial dysfunction in rats with heart failure. J Cardiovasc Pharmacol 2009; 53 (1): 9–17.
16. Milliez P, Messaoudi S, Nehme J et al. Beneficial effects of delayed ivabradine treatment on cardiac anatomical and electrical remodeling in rat severe chronic heart failure. Am J Physiol Heart Circ Physiol 2009; 296 (2): H435–441.
17. Maczewski M, Mackiewicz U. Effect of metoprolol and ivabradine on left ventricular remodelling and Ca2+ handling in the post-infarction rat heart. Cardiovasc Res 2008; 79 (1): 42–51.
18. Colin P, Ghaleh B, Monnet X et al. Contributions of heart and contractility to myocardial oxygen balance during exercise. Am J Physiol Heart Circ Physiol 2003; 284: 676–82.
19. Vilaine JP, Thollon C, Villeneuve N et al. Procoralan, a new selective If current inhibitor. Eur Heart J 2003; 5 (Suppl. G): 26–35.
20. Бубнова М.Г. Оптимизация терапии больного с ишемической болезнью сердца в клинической практике: доказанная эффективность селективного ингибитора If-каналов ивабрадина. Кардиосоматика. 2013; 4 (2): 27–36. / Bubnova M.G. Optimizatsiia terapii bol'nogo s ishemicheskoi bolezn'iu serdtsa v klinicheskoi praktike: dokazannaia effektivnost' selektivnogo ingibitora If-kanalov ivabradina. Сardiosomatics. 2013; 4 (2): 27–36. [in Russian]
21. Davis K, Dietrich E. Ivabradine (Corlanor) for Heart Failure. Am Fam Physician 2016; 93 (8): 682–4.
22. Weeda ER, Nguyen E, White CM. The Role of Ivabradine in the Treatment of Patients With Cardiovascular Disease. Ann Pharmacother 2016 Feb 25. pii: 1060028016631571.
23. Foster JL, Bobadilla RV. Ivabradine, a novel medication for treatment of heart failure with reduced ejection fraction. J Am Assoc Nurse Pract 2016 May 24. DOI: 10.1002/2327-6924.12371.
24. Карпов Ю.А., Деев А.Д. Программа АЛЬТЕРНАТИВА – исследование АнтиангинаЛЬной эффекТивности и пЕРеносимости кораксаНА (ивабрадина) и оценка качесТва жИзни пациентоВ со стАбильной стенокардией: результаты эпидемиологического исследования. Кардиология. 2008; 5: 30–5. / Karpov Yu.A., Deev A.D. Programma AL''TERNATIVA – issledovanie AntianginaL''noy effekTivnosti i pERenosimosti koraksaNA (ivabradina) i otsenka kachesTva zhIzni patsientoV so stAbil'noy stenokardiey: rezul'taty epidemiologicheskogo issledovaniya. Kardiologiya. 2008; 5: 30–5. [in Russian]
25. Национальные рекомендации по диагностике и лечению стабильной стенокардии. Кардиоваскулярная терапия и профилактика. 2008; 7 (6) (Прил. 4). / Natsional'nye rekomendatsii po diagnostike i lecheniyu stabil'noy stenokardii. Kardiovaskulyarnaya terapiya i profilaktika. 2008; 7 (6) (Pril. 4). [in Russian]
26. Пономарева А.И., Компаниец О.Г., Линчак Р.М., Иванчура Г.С. Пульсурежающая фармакотерапия у пациентов с гипертонической болезнью и хронической сердечной недостаточностью: теория и проблемы применения в реальной клинической практике. Системные гипертензии. 2016; 1: 52–7. / Ponomareva A.I., Kompaniets O.G., Linchak R.M., Ivanchura G.S. Pul'surezhayushchaya farmakoterapiya u patsientov s gipertonicheskoy bolezn'yu i khronicheskoy serdechnoy nedostatochnost'yu: teoriya i problemy primeneniya v real'noy klinicheskoy praktike. Sistemic Hypertension. 2016; 1: 52–7. [in Russian]
27. Марцевич С.Ю., Кутишенко Н.П., Деев А.Д. Оригинальные препараты и дженерики в кардиологии. Можно ли решить проблему взаимозаменяемости. Вестн. Росздравнадзора. 2009; 4: 48–51. / Martsevich S.Yu., Kutishenko N.P., Deev A.D. Original'nye preparaty i dzheneriki v kardiologii. Mozhno li reshit' problemu vzaimozamenyaemosti. Vestn. Roszdravnadzora. 2009; 4: 48–51. [in Russian]
28. Tрухан Д.И. Рациональная фармакотерапия в кардиологии сквозь призму коморбидности и лекарственной безопасности. Справочник поликлинического врача. 2015; 1: 26–31. / Trukhan D.I. Ratsional'naya farmakoterapiya v kardiologii skvoz' prizmu komorbidnosti i lekarstvennoy bezopasnosti. Handbook for Practitioners Doctors. 2015; 1: 26–31. [in Russian]
________________________________________________
1.Rossiyskiy statisticheskiy ezhegodnik-2014, Federal'naya sluzhba gosudarstvennoy statistiki. elektronnyy resurs: www.gks.ru [in Russian]
2. ESC guidelines on the management of stable coronary artery disease, 2013. Eur Heart J 2013; 34: 2949–3003.
3. Diagnostika i lechenie khronicheskoy ishemicheskoy bolezni serdtsa. Klinicheskie rekomendatsii MZ RF, 2013 g. http://cardioweb.ru/klinicheskie-rekomendatsii. [in Russian]
4. ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2012; 60: e44–164.
5. Copie X, Hnatkova K, Staunton A et al. Predictive power of increased heart rate versus depressed left ventricular ejection fraction and heart rate variability for risk stratification after myocardial infarction. Results of a two-year follow-up study. J Am Coll Cardiol 1996; 27 (2): 270–6.
6. Diaz A, Bourassa MG, Guertin M-C, Tardif J-C. Long-term prognostic value of resting heart rate in patients with suspected or proven coronary artery disease. Eur Heart J 2005; 26 (10): 967–74.
7. Pocock SJ, Wang D, Pfeffer MA et al. Predictors of mortality and morbidity in patients with chronic heart failure. Eur Heart J 2006; 27 (1): 65–75.
8. Gillum RF, Makuc DM, Feldman JJ. Pulse rate, coronary heart disease, and death: the NHANES I Epidemiologic Follow-up Study. Am Heart J 1991; 121 (1): 172–7.
9. Castelli WP, Levy D, Wilson PWF, Kannel W. Sudden death: The view from Framingham. The Prevention of Sudden Death. Ed. by JB Kostis, M Sanders. New York: E Wiley-Liss, 1990; p. 1–8.
10. Janssen I, Katzmarzyk PT, Church TS, Blair SN. The Cooper Clinic Mortality Risk Index: clinical score sheet for men. Am J Prev Med 2005; 29 (3): 194–203.
11. Erofeeva S.B., Maneshina O.A. Mesto ivabradina – pervogo If-ingibitora izbiratel'nogo i spetsificheskogo deystviya, v lechenii serdechno-sosudistykh zabolevnaiy. Kachestvennaya klinicheskaya praktika. 2006; 1: 10–22. [in Russian]
12. Fox K, Ford I, Steg PG et al. Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebo-controlled trial. Lancet 2008; 372 (9641): 807–16.
13. Swedberg K, Komajda M, Bohm M et al. Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet 2010; 376 (9744): 875–85.
14. Riccioni G. Ivabradine: recent and potential applications in clinical practice. Exp Opin Pharmacother 2011; 12 (3): 443–50.
15. Ulu N, Henning RH, Goris M et al. Effects of ivabradine and metoprolol on cardiac angiogenesis and endothelial dysfunction in rats with heart failure. J Cardiovasc Pharmacol 2009; 53 (1): 9–17.
16. Milliez P, Messaoudi S, Nehme J et al. Beneficial effects of delayed ivabradine treatment on cardiac anatomical and electrical remodeling in rat severe chronic heart failure. Am J Physiol Heart Circ Physiol 2009; 296 (2): H435–441.
17. Maczewski M, Mackiewicz U. Effect of metoprolol and ivabradine on left ventricular remodelling and Ca2+ handling in the post-infarction rat heart. Cardiovasc Res 2008; 79 (1): 42–51.
18. Colin P, Ghaleh B, Monnet X et al. Contributions of heart and contractility to myocardial oxygen balance during exercise. Am J Physiol Heart Circ Physiol 2003; 284: 676–82.
19. Vilaine JP, Thollon C, Villeneuve N et al. Procoralan, a new selective If current inhibitor. Eur Heart J 2003; 5 (Suppl. G): 26–35.
20. Bubnova M.G. Optimizatsiia terapii bol'nogo s ishemicheskoi bolezn'iu serdtsa v klinicheskoi praktike: dokazannaia effektivnost' selektivnogo ingibitora If-kanalov ivabradina. Сardiosomatics. 2013; 4 (2): 27–36. [in Russian]
21. Davis K, Dietrich E. Ivabradine (Corlanor) for Heart Failure. Am Fam Physician 2016; 93 (8): 682–4.
22. Weeda ER, Nguyen E, White CM. The Role of Ivabradine in the Treatment of Patients With Cardiovascular Disease. Ann Pharmacother 2016 Feb 25. pii: 1060028016631571.
23. Foster JL, Bobadilla RV. Ivabradine, a novel medication for treatment of heart failure with reduced ejection fraction. J Am Assoc Nurse Pract 2016 May 24. DOI: 10.1002/2327-6924.12371.
24. Karpov Yu.A., Deev A.D. Programma AL''TERNATIVA – issledovanie AntianginaL''noy effekTivnosti i pERenosimosti koraksaNA (ivabradina) i otsenka kachesTva zhIzni patsientoV so stAbil'noy stenokardiey: rezul'taty epidemiologicheskogo issledovaniya. Kardiologiya. 2008; 5: 30–5. [in Russian]
25. Natsional'nye rekomendatsii po diagnostike i lecheniyu stabil'noy stenokardii. Kardiovaskulyarnaya terapiya i profilaktika. 2008; 7 (6) (Pril. 4). [in Russian]
26. Ponomareva A.I., Kompaniets O.G., Linchak R.M., Ivanchura G.S. Pul'surezhayushchaya farmakoterapiya u patsientov s gipertonicheskoy bolezn'yu i khronicheskoy serdechnoy nedostatochnost'yu: teoriya i problemy primeneniya v real'noy klinicheskoy praktike. Sistemic Hypertension. 2016; 1: 52–7. [in Russian]
27. Martsevich S.Yu., Kutishenko N.P., Deev A.D. Original'nye preparaty i dzheneriki v kardiologii. Mozhno li reshit' problemu vzaimozamenyaemosti. Vestn. Roszdravnadzora. 2009; 4: 48–51. [in Russian]
28. Trukhan D.I. Ratsional'naya farmakoterapiya v kardiologii skvoz' prizmu komorbidnosti i lekarstvennoy bezopasnosti. Handbook for Practitioners Doctors. 2015; 1: 26–31. [in Russian]
Авторы
М.А.Гуревич*, Н.А.Кузьменко
ГБУЗ МО Московский областной научно-исследовательский клинический институт им. М.Ф.Владимирского. 129110, Россия, Москва, ул. Щепкина, д. 61/2
*magurevich@mail.ru
________________________________________________
M.A.Gurevich*, N.A.Kuzmenko
M.F.Vladimirskiy Moscow Regional Clinical Institute. 129110, Russian Federation, Moscow, ul. Shchepkina, d. 61/2
*magurevich@mail.ru