Efficacy profile of ivabradine in patients with heart failure plus angina pectoris

Borer, J. S., Swedberg, K., Komajda, M., Ford, I. , Tavazzi, L., Böhm, M., Depre, C., Wu, Y., Maya, J. and Dominjon, F. (2017) Efficacy profile of ivabradine in patients with heart failure plus angina pectoris. Cardiology, 136(2), pp. 138-144. (doi:10.1159/000449243) (PMID:27614723)

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Abstract

Objectives: In the Systolic Heart Failure Treatment with the If Inhibitor Ivabradine Trial (SHIFT), slowing of the heart rate with ivabradine reduced cardiovascular death or heart failure hospitalizations among patients with systolic chronic heart failure (CHF). Subsequently, in the Study Assessing the Morbidity-Mortality Benefits of the If Inhibitor Ivabradine in Patients with Coronary Artery Disease (SIGNIFY) slowing of the heart rate in patients without CHF provided no benefit for cardiovascular death or nonfatal myocardial infarction (primary composite end point), with secondary analyses suggesting possible harm in the angina subgroup. Therefore, we examined the impact of ivabradine in the patients with CHF plus angina in SHIFT. Methods: SHIFT enrolled adults with stable, symptomatic CHF, a left ventricular ejection fraction ≤35% and a sinus rhythm with a resting heart rate ≥70 bpm. Outcomes were the SHIFT and SIGNIFY primary composite end points and their components. Results: Of 6,505 patients in SHIFT, 2,220 (34%) reported angina at randomization. Ivabradine numerically, but not significantly, reduced the SIGNIFY primary composite end point by 8, 11 and 11% in the SHIFT angina subgroup, nonangina subgroup and overall population, respectively. Ivabradine also reduced the SHIFT primary composite end point in all 3 subgroups. Conclusions: In SHIFT, ivabradine showed consistent reduction of cardiovascular outcomes in patients with CHF; similar results were seen in the subgroup of SHIFT patients with angina.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Ford, Professor Ian
Authors: Borer, J. S., Swedberg, K., Komajda, M., Ford, I., Tavazzi, L., Böhm, M., Depre, C., Wu, Y., Maya, J., and Dominjon, F.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Cardiology
Publisher:Karger Publishers
ISSN:0008-6312
ISSN (Online):1421-9751
Published Online:10 September 2016
Copyright Holders:Copyright © 2016 Karger AG
First Published:First published in Cardiology 136(2): 138-144
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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