Procorolan - Caring for your heart
Procorolan is a breakthrough drug that has been designed to help treat heart-failure patients, and reduces the number of deaths in these patients.
"It's a novel drug that works specifically in slowing the heart rate," explains Dr Edward Chung of Cardiologist Associates Limited. "A necessity in heart-failure patients, it is the first in its class of medication," Dr Chung said.
"Under normal circumstances, our heart will be running 70-100 beats per minute. But if you deve-lop heart failure, the heart is not able to pump and, therefore, what the body does in an effort to try and increase the output of the heart, is to make the heart beat faster," he explained. Initially, this compensating reaction was not viewed negatively. But over time, doctors realised that it could be fatal to patients.
"In the initial stage, that was something we didn't think much about. But we were beginning to recognise that that increased heart rate that exists in heart-failure patients is actually detrimental because the more the heart beats, the more energy it uses and, therefore, the quicker the heart starts to fail. So it's like a vicious cycle, " he said.
According to Dr Chung, various drugs have been deve-loped to remedy this problem, which have included those to stimulate the heart and make it beat stronger or decrease the resistance that the heart has to pump against.
"In spite of all of these drugs, what they are finding is that we can only improve their mortality slightly, so despite this, a lot of heart patients end up dying from heart failure," he said.
Common causes of heart failure include; hypertension, diabetes, coronary artery disease and infection within the heart muscle.
What Procorolan (locally distributed by HD Hopwood and Company Limited) does is to ultimately decrease the number of heart-failure patients who die.
"The theory was that if we use medications to slow the heart rate bringing it down to what we call the ideal heart rate, they would live longer, it would decrease the need to be in the hospital, " he said.
A SHIFT (Systolic Heart Failure Treatment with the If Inhibitor Ivabradine Trial) study was conducted with more than 6,500 heart-failure patients from 37 countries (with heart beats per minute (bpm) of above 70 bpm). They were monitored for 23 months, and it was found that within three months, patients saw improvements.
The study found that there was an 18 per cent reduction in death from heart disease in patients who took Procorolan in conjunction with other medications. There was also a reduction in hospitalisation.
Previous research showed that 75 per cent of heart-failure patients died after five years. "It means that after five years, only 25 per cent are alive. Therefore, whatever you use to treat this condition is going to be very significant."
Dr Chung has seen good results in his local patients.
"One that's so striking is a 35-year-old patient I had who was always in heart failure, average heart rate was about 110 and she couldn't tolerate a lot of the other drugs.
"I started her on this medication, and within less than a month she reported that she felt better. Her heart rate had decreased significantly. Instead of being at 110, it was reduced to 80. She was now able to climb stairs and do a lot of things she couldn't do before," he said.
He notes that the drug is costly, but that is not unusual with new drugs. However, he believes it has great saving potential for the health-care system.
"We think that it's a significant advance that has potential benefits from our observation since we have such a high incidence of heart failure," he said of the Jamaican context.