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Comparative efficacy of ivabradine versus beta-blockers in patients with mitral stenosis in sinus rhythm: systematic review and meta-analysis

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Abstract

Background Patients with mitral valve stenosis have increased heart rate. HR reduction is known as an important treatment and therapy strategy for patients with mitral valve stenosis. Aim of the review The aim of this systematic review and meta-analysis was to compare the efficacy of ivabradine versus beta-blockers in patients with mitral stenosis in sinus rhythm. Methods Randomized controlled trials were searched in Cochrane Library, PubMed, Web of Science, CRD, Scopus, and Google Scholar with no start time limitation and ending June 2018. Risk of bias across was assessed by the Cochrane Risk of Bias Assessment tool. Fixed effects models were used to combine the results and the mean difference with a 95% confidence interval. This meta-analysis was performed using Meta Package in R software. Results Five studies entered meta-analysis. The total number of patients treated with ivabradine and beta-blockers was 178 and 178 respectively. The results showed that the mean of maximum HR and HR at rest was lower at about 5.03 units and upper 4.32 units respectively with use of ivabradine compared with the use of beta-blockers. These values were statistically significant. Conclusion It seems that the efficacy of ivabradine is good in comparison with betablockers, but it still requires more clinical trials.

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Acknowledgments

The authors would like to thank Dr. Masoud Mozafari for his facilitative and collaborative efforts to this research.

Funding

This work was supported by Health management and economics research center, Iran University of Medical Sciences “[Grant Number: 95-02-163-28619]”

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Authors and Affiliations

  1. Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran

    Nashmil Ghadimi, Sara Kaveh & Hossein Hosseinifard

  2. Health Economics Group, Institute of Health & Society, Newcastle University, Newcastle, UK

    Hossein Shabaninejad

  3. Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Rabat, Morocco

    Alaadine Lijassi

  4. Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran

    Ali Zahed Mehr

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  1. Nashmil Ghadimi
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Correspondence to Hossein Hosseinifard.

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Ghadimi, N., Kaveh, S., Shabaninejad, H. et al. Comparative efficacy of ivabradine versus beta-blockers in patients with mitral stenosis in sinus rhythm: systematic review and meta-analysis. Int J Clin Pharm 41, 22–29 (2019). https://doi.org/10.1007/s11096-018-00778-z

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