Coronary disease & ACSResearch article

Safety and efficacy of ivabradine in the treatment of patients with acute myocardial infarction: a real-world propensity score matching study

Eur Heart J Acute Cardiovasc CarePublished

  • real-world propensity score matching study
  • 82 hospitals in Tianjin, China
  • 2010 and 2024
  • pre-specified subgroup analyses

Authors' conclusion

In this large real-world AMI cohort, in-hospital ivabradine use was associated with higher in-hospital and 1-year mortality, without clear evidence of benefit for other secondary outcomes.

Study context

Population
Patients with acute myocardial infarction (AMI) admitted to hospitals in Tianjin, Chinapatients with AMI admitted to 82 hospitals
Participants
136,033 patients
Comparison
In-hospital ivabradine use vs controls
Outcome
In-hospital mortality and 1-year cardiac mortality

Main finding

As reported in the abstract

In-hospital mortality — ivabradine vs controlsAdjusted odds ratio (95% CI)P value
higher with ivabradine; after PSM, fully adjusted model
1.66(1.19–2.32)
P = 0.003
higher with ivabradine; after PSM, fully adjusted model. 1-year cardiac mortality — ivabradine vs controls: aHR 1.22 (95% CI 1.01-1.47); P = 0.043; higher with ivabradine; after PSM, fully adjusted model
1.66(1.19–2.32)
P = 0.003

Secondary outcomes

OutcomeaHR (95% CI)P value
1-year all-cause mortality (secondary) · higher with ivabradine1.19 (1.01–1.40)P = 0.040

Other secondary outcomes

No significant differences

Subgroup analyses

Stronger associations among patients aged ≥65 years
Mortality association most pronounced among patients receiving ivabradine without concomitant beta-blocker

Sensitivity analyses

Directionally consistent findings

Original publication

Safety and efficacy of ivabradine in the treatment of patients with acute myocardial infarction: a real-world propensity score matching study. Eur Heart J Acute Cardiovasc Care. Published 15 June 2026. doi:10.1093/ehjacc/zuag084

Summarised from the published abstract; every number is checked against it