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ABSTRACT: PurposeElevated levels of serum inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP) represent independent risk
factors for further cardiovascular events. In an atherosclerosis model, selective heart rate (HR) reduction with ivabradine
has been shown to decrease markers of vascular oxidative stress, to improve endothelial function, and to reduce atherosclerotic
plaque formation. We hypothesized that the addition of ivabradine to standard medical therapy has a beneficial effect on markers
of inflammatory stress in acute coronary syndromes (ACS) patients.
MethodsRIVIERA is a unicenter, randomized, double-blind, placebo-controlled trial involving 1,270 patients of either gender admitted
to hospital with non ST elevation ACS. The primary study aim is to evaluate the effects of ivabradine therapy, initiated at
the time of hospital admission, on hs-CRP levels. There is also a combined secondary endpoint i.e. to assess the effects of
ivabradine on the occurrence of death, nonfatal myocardial infarction, recurrent symptomatic ischemia, urgent revascularization,
and cardiac arrest at 30-days and 1-year follow up.
ConclusionWe hypothesize that ivabradine therapy, when started immediately after hospital admission for ACS, will result in the reduction
of hs-CRP levels and the improvement of cardiovascular outcome.
Cardiovascular Drugs and Therapy 06/2009; 23(3):243-247. · 2.67 Impact Factor