AIM: To study effects of ivabradin on clinicohemodynamic and prognostic 
parameters in patients after myocardial infarction (MI) with systolic chronic 
cardiac failure (SCCF).
MATERIAL AND METHODS: A population-based randomized prospective trial enrolled 
49 patients (40 males--81.6%, mean age 63.1 +/- 8.1 years) with sinus rhythm and 
a longer than 3 month history of MI. The patients were randomized into 2 groups: 
23 patients of group 1 received standard treatment plus ivabradin, 26 patients 
of group 2 received standard treatment alone. Follow-up was 36.1 +/- 6.2 months. 
We analysed the trend in heart rate (HR), blood pressure (BP), parameters of 
echocardiography, ECG, levels of electrolytes, creatinin in blood plasma, 
frequency of hospitalizations, recurrent non-fatal MI and lethality (combined 
endpoint).
RESULTS: In the end of the trial ivabradin significantly decreased HR from 71 to 
64 b/m. Frequency of combined end point of efficacy was 30.4 and 50% in group 1 
and 2, respectively. In group 1 primary end point in high baseline HR occurred 
more frequently than in HR < 70 b/m in 6 (50%) and 1 (9.1%) cases, respectively, 
but these differences were not significant (p = 0.068). In group 2 the 
differences were significant--9 (90%) and 4 (25%) cases, respectively (p = 
0.004). By none of the parameters of ECG, plasma electrolytes, creatinine level 
significant intergroup differences were found.
CONCLUSION: In the same trend in BP and ECG, group 1 patients showed significant 
and more pronounced HR lowering than group 2 patients. Addition of ivabradin to 
standard treatment of SCCF after MI promoted less frequency of hospitalizations, 
recurrent non-fatal MI, fatal cardiovascular events. This effect was especially 
strong in high baseline HR.