Effects of ivabradine on vascular endothelial function in patients with coronary artery disease： a meta-analysis

CHEN Congling; YANG Xian; WU Han; YING Jiachen; ZHANG Ruobin; LAN Xi; ZHANG Jinping

doi:10.6039/j.issn.1001-0408.2024.06.19

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Effects of ivabradine on vascular endothelial function in patients with coronary artery disease： a meta-analysis

更新时间：2024-04-09

- Effects of ivabradine on vascular endothelial function in patients with coronary artery disease： a meta-analysis
- ZHONGGUO YAOFANG Vol. 35, Issue 6, Pages: 744-749(2024)
- 作者机构：
  
  1.南京鼓楼医院药学部，南京　210008
  2.中国药科大学基础医学与临床药学学院，南京　211198
  3.南京鼓楼医院心脏科，南京　210008
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2024.06.19
  CLC： R972
- Published：30 March 2024，
  
  Received：18 September 2023，
  
  Revised：20 February 2024，
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陈琮玲,杨贤,吴韩等.伊伐布雷定对冠心病患者血管内皮功能影响的Meta分析 ^Δ[J].中国药房,2024,35(06):744-749.

CHEN Congling,YANG Xian,WU Han,et al.Effects of ivabradine on vascular endothelial function in patients with coronary artery disease： a meta-analysis[J].ZHONGGUO YAOFANG,2024,35(06):744-749.
陈琮玲,杨贤,吴韩等.伊伐布雷定对冠心病患者血管内皮功能影响的Meta分析 ^Δ[J].中国药房,2024,35(06):744-749. DOI： 10.6039/j.issn.1001-0408.2024.06.19.

CHEN Congling,YANG Xian,WU Han,et al.Effects of ivabradine on vascular endothelial function in patients with coronary artery disease： a meta-analysis[J].ZHONGGUO YAOFANG,2024,35(06):744-749. DOI： 10.6039/j.issn.1001-0408.2024.06.19.

摘要

目的

评价伊伐布雷定对冠心病患者血管内皮功能的影响。

方法

检索PubMed、Embase、Cochrane图书馆、Web of Science、中国知网、万方数据、维普网、中国生物医学文献数据库，收集伊伐布雷定（干预组）对比安慰剂或β受体阻滞剂（对照组）的随机对照试验（RCT），检索时限为各数据库建库起至2023年3月20日。筛选文献、提取数据和评价质量后，采用RevMan 5.4软件进行Meta分析。

结果

共纳入12项RCT，共计1 206例患者。Meta分析结果显示，干预组患者的内皮依赖性血管舒张功能（FMD）[MD＝1.71，95%CI（0.96，2.46），

＜0.000 01]、一氧化氮（NO）[MD＝5.80，95%CI（5.02，6.59），

＜0.000 01]水平均显著高于对照组，内皮素1（ET-1）水平显著低于对照组[MD＝－7.45，95%CI（－8.42，－6.47），

＜0.000 01]。两组患者的非内皮依赖性血管舒张功能（NMD）比较，差异无统计学意义[MD＝0.13，95%CI（－0.74，1.00），

＝0.77]。按照对照组用药和干预时间的不同进行的亚组分析结果显示，与安慰剂比较，使用伊伐布雷定患者的FMD水平显著升高（

＜0.05）；与安慰剂、β受体阻滞剂比较，使用伊伐布雷定患者的NO水平均显著升高（

＜0.05）、ET-1水平均显著降低（

＜0.05）。无论干预时间长短，干预组患者的FMD、NO、ET-1水平均较对照组显著改善（

＜0.01），NMD比较差异无统计学意义（

＞0.05）。

结论

伊伐布雷定能显著改善冠心病患者的血管内皮功能。

Abstract

OBJECTIVE

To evaluate the effects of ivabradine on vascular endothelial function in patients with coronary artery disease.

METHODS

PubMed， Embase， the Cochrane Library， Web of Science， CNKI， Wanfang Data， VIP and CBM databases were retrieved to collect randomized controlled trials （RCTs） about ivabradine （intervention group） versus placebo or β-blocker （control group） from the inception to Mar. 20th 2023. The meta-analysis was performed by using RevMan 5.4 software after literature screening， data extraction and quality evaluation.

RESULTS

A total of 12 RCTs were included， involving 1 206 patients. The results of meta-analysis showed that the levels of flow-mediated dilation （FMD） [MD＝1.71， 95%CI （0.96， 2.46），

＜0.000 01] and nitric oxide （NO） [MD＝5.80， 95%CI （5.02， 6.59），

＜0.000 01] in the intervention group were significantly higher than control group， while endothelin-1（ET-1） level was significantly lower than control group [MD＝－7.45， 95%CI （－8.42，－6.47），

＜0.000 01]. There was no statistical significance in nitroglycerin-mediated dilation （NMD） level between 2 groups [MD＝0.13， 95%CI（－0.74， 1.00），

＝0.77]. Subgroup analyses based on the different medications and intervention time in the control group showed better improvement in FMD level of patients receiving ivabradine， compared with placebo （

＜0.05）； compared with placebo and β-blocker， the level of NO in patients receiving ivabradine was improved significantly （

＜0.05）， while ET-1 level was decreased significantly （

＜0.05）. Regardless of the duration of the intervention， the levels of FMD， NO， and ET-1 in the intervention group were significantly improved compared to the control group （

＜0.01）， while the difference in NMD was not statistically significant （

＞0.05）.

CONCLUSIONS

Ivabradine can improve vascular endothelial function in patients with coronary artery disease.

关键词

伊伐布雷定血管内皮功能冠心病Meta分析

Keywords

vascular endothelial functioncoronary heart diseasemeta-analysis

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