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GENERAL CARDIOLOGY
Ivabradine is a pure heart-rate-lowering agent that is a specific inhibitor of the If current in the sinoatrial node; currently it is licensed for the treatment of angina. The BEAUTIFUL (morBidity–mortality EvAlUaTion of the If inhibitor ivabradine in patients with coronary disease and left-ventricULar dysfunction) trial aimed to determine if heart rate lowering with ivabradine could reduce cardiovascular death and mortality in patients with stable coronary artery disease and impaired systolic function (<40%), as several studies have demonstrated that a high heart rate is an independent predictor of both cardiovascular and all-cause mortality.
A total of 10 917 eligible patients were enrolled in a randomised, double-blind, placebo-controlled, parallel-group manner. Of these, 5479 patients received 5 mg ivabradine, with the intention of increasing to the target dose of 7.5 mg twice a day, and 5438 received matched placebo in addition to their other cardiac drugs. The primary end point was a
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