ISSN: 0300-8932 Factor de impacto 2023 7,2
Vol. 7. Núm. D.
Páginas 46D-52D (Junio 2007)

Novedades en la reducción de la frecuencia cardiaca
Eficacia antianginosa de la ivabradina. Mecanismos de acción diferenciales con otros fármacos antianginosos

The Antianginal Effects of Ivabradine. Its Mechanism of Action Differentiates It from Other Antianginal Drugs

Jordi Bruguera-Cortada¿Cosme García-García

Opciones

La reducción de la frecuencia cardiaca es un instrumento básico en el tratamiento de la angina crónica estable, con efectos tanto en los síntomas como en el pronóstico. Los bloqueadores beta, y en menor medida los calcioantagonistas no dihidropiridínicos, ejercen parte de su eficacia antianginosa por este mecanismo. La ivabradina inhibe de forma selectiva la corriente If en las células del nodo sinusal y logra una marcada prolongación del tiempo de despolarización diastólica espontánea y, con ello, una significativa reducción de la frecuencia cardiaca, tanto en reposo como durante el ejercicio, sin otros efectos hemodinámicos, a diferencia de los antagonistas del calcio o los bloqueadores beta, y con potencia similar a la de éstos. Los estudios en voluntarios sanos y en angina de esfuerzo crónica estable limitante han demostrado la eficacia frente a placebo con diferentes dosis. En comparación con los bloqueadores beta o antagonistas del calcio, o combinada con ellos, también se ha objetivado una franca mejoría de los síntomas anginosos y una mayor tolerancia al esfuerzo.

Palabras clave

Angina estable
Frecuencia cardiaca
Nodo sinusal
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