期刊
EUROPEAN HEART JOURNAL
卷 34, 期 29, 页码 2263-2270出版社
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/eht101
关键词
BEAUTIFUL; SHIFT; Ivabradine; Heart rate; LV function; Prognosis
资金
- Servier, France
- National Institute for Health Research [NF-SI-0611-10149] Funding Source: researchfish
To test the effect of ivabradine on the outcomes in a broad population with left-ventricular (LV) systolic dysfunction with coronary artery disease (CAD) and/or heart failure (HF). Individual trial data from BEAUTIFUL and SHIFT were pooled to evaluate the effect of ivabradine on the outcomes in patients with LV dysfunction and heart rate 70 b.p.m. The pooled population (n 11 897; baseline age 62.3 10.4 years, heart rate 79.6 9.2 b.p.m., and LV ejection fraction 30.3 5.6) was well treated according to current recommendations (87 beta-blockers, 90 reninangiotensin system inhibitors). Median follow-up was 21 months. Treatment with ivabradine was associated with a 13 relative risk reduction for the composite of cardiovascular mortality or HF hospitalization (P 0.001 vs. placebo); this was driven by HF hospitalizations (19, P 0.001). There were also significant relative risk reductions for the composite of cardiovascular mortality, HF hospitalizations, or myocardial infarction (MI) hospitalization (15, P 0.001); cardiovascular mortality and non-fatal MI (10, P 0.023); and MI hospitalization (23, P 0.009). Similar results were found in patients with differing clinical profiles. Ivabradine was well tolerated. Ivabradine may be important for the improvement of clinical outcomes in patients with LV systolic dysfunction and heart rate 70 b.p.m., whatever the primary clinical presentation (CAD or HF) or clinical status (NYHA class).
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