The benefits of ivabradine are independent of resting heart rate

Evaluation of: Tardif JC, Ponikowski P, Kahan T; on behalf of the ASSOCIATE investigators. Effects of ivabradine in patients with stable angina receiving beta-blockers according to baseline heart rate: an analysis of the ASSOCIATE study. Int. J. Cardiol. pii:S0167-5273(12)01385-X (2012). Chronic stable angina pectoris is the most common manifestation of coronary artery disease. A large body of evidence points to high resting heart rate (HR) as a risk factor for mortality in various populations, including patients with cardiovascular disease. Elevated HR is an important pathophysiological variable that increases myocardial oxygen demand and also limits tissue perfusion by reducing the duration of diastole, during which most myocardial perfusion occurs. Large epidemiological trials have established that elevated resting HR is a prognostic factor for cardiovascular events and mortality in healthy individuals and in patients with myocardial infarction, stable coronary artery disease and heart failure. The cla...