Comparison of the safety and efficacy of ivabradine and nebivolol mono- and combination therapies in the treatment of stable angina pectoris patients with left ventricular dysfunction

We aimed to investigate the pharmacoeconomic efficacy of ivabradine and nebivolol in treatment of stable angina pectoris patients with left ventricular dysfunction prospectively. Pharmacoeconomic analysis was performed by using cost minimization analysis, and cost effectiveness analysis. After 6 months treatment LVEF for the nebivolol group (17 patients, 50%) improved by (38 ± 6.5) to (41 ± 3.2), (p>0.05) and for the ivabradine group (17 patients, 50%) (37 ± 5.4) to (41 ± 2.3), (p>0.05), mean MET value in the nebivolol group increased from (3.7 ± 1.2) to (5.5 ± 1.6), (p>0.05), versus from (3.6 ± 1.5) to (5.5 ± 1.4), (p>0.05) in the ivabradine group, cost minimization analysis results showed a difference in the total cost of treatment was US$ 5288.7 in favor of nebivolol. The findings suggest that nebivolol is more cost-effective than ivabradine in the treatment of patients with left ventricular dysfunction

Relationship between Duke Treadmill Score and platelet volume indices in predicting coronary artery disease

Purpose — Platelet volume indices are associated with poor cardiovascular outcomes. The Duke Treadmill Score (DTS) is a composite index that is based on the results from the exercise test. The purpose of this study was to investigate the relationship between the DTS and platelet volume indices in patients with suspected coronary artery disease (CAD). Methods — A total of 1205 participants were enrolled in the study. Complete blood counts were obtained. All participants underwent an exercise test. The DTS were calculated after exercise. Demographic, clinical and echocardiographic characteristics of the patients were recorded. Results — Platelet distribution width (PDW) and especially mean platelet volume (MPV) values increase with higher DTS risk group irrespective of CAD and risk groups which is also found to be statistically significant (P<0.001). The power of the relation was powerful (r=0.911). A powerful positive relation was found between risk level and PDW (P<0.001, r=0.319). Paralleled with DTS, MPV and PDW values of the patients with CAD, hypertension, diabetes mellitus, smoking and hyperlipidemia were higher compared to those without, while MPV and PDW values were lower for the patients taking beta-blockers, angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers, diuretics, aspirin and statins. When MPV (f1) and PDW (%) values were compared between groups, there was a high statistical significance between most groups. Conclusion — We found an independent association between MPV, PDW and DTS