The study was aimed to assess the efficacy and safety of treating coronary heart disease (CHD) patients complicated with Chronic Obstructive Pulmonary Disease (COPD) using the combination of tolerable doses of beta-blocker bisoprolol and inhibitor If-channel ivabradine, compared with bisoprolol alone. PARICIPANTS. 50 patients with stable angina and COPD were included (88% men, mean age 62.8±7.2 years). All patients received bisoprolol, the dose of which was titrated until the clinical signs of intolerance. Then, the patients were randomized into two groups: patients of the first group continued to take bisoprolol and patients of the second group were added ivabradine (5–15 mg).

Results: Combination therapy resulted in further decrease of heart rate (HR) to an average of 62±4 bpm over 6 month of follow–up. This was associated with additional decrease of the number of angina attacks (by 4.7±4.4 per week vs. 2.5±4.7, p<0.05) and increase of quality of life (p<0.05). Only in combination therapy group there was also the decrease of broncholytics consumption (from 2.9±3.2 to 1.9±2.7 per week, p<0.05). Pulse wave velocity (PWV) estimated by Arteriograph (TensioClinic «Meditech») decrease significant in both groups, but no difference delta PWV between groups.

Conclusion: The combination of tolerable doses of bisoprolol and ivabradine is safe and allows to achieve adequate HR decrease. This is associated with maximal antianginal effect, decrease in the need for broncholytic therapy, improvement of the quality of life compared with the treatment with bisoprolol alone. We did not find the influences of ivabradine on the arterial stiffness.