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Efficacy and safety...
Efficacy and safety of ivabradine in patients with severe chronic systolic heart failure (from the SHIFT study)
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Borer, J. S. (författare)
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Böhm, M. (författare)
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Ford, I. (författare)
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Robertson, M. (författare)
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Komajda, M. (författare)
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Tavazzi, L. (författare)
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- Swedberg, Karl, 1944 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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(creator_code:org_t)
- Elsevier BV, 2014
- 2014
- Engelska.
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Ingår i: American Journal of Cardiology. - : Elsevier BV. - 0002-9149. ; 113:3, s. 497-503
- Relaterad länk:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- A post hoc analysis of Systolic Heart failure treatment with the I f inhibitor ivabradine Trial (SHIFT) explored the efficacy and safety of ivabradine in severe heart failure (HF) as denoted by left ventricular ejection fraction (LVEF) ≤20% and/or New York Heart Association (NYHA) class IV. The SHIFT population (LVEF ≤35%, heart rate ≥70 beats/min, and sinus rhythm) comprised 712 patients with severe (defined previously) and 5,973 with less severe (NYHA classes II or III and LVEF >20%) HF, all randomized to ivabradine or placebo on a background of guideline-defined standard care. The rate of primary composite end point of cardiovascular death or HF hospitalization with placebo was higher in severe (42%) than less severe (27%) HF (p <0.001). Treatment with ivabradine in severe HF was associated with relative risk reductions indistinguishable from those of less severe disease for the primary end point (16% reduction), all-cause death (22%), cardiovascular death (22%), HF death (37%), and HF hospitalization (17%; all p values for interaction: NS). NYHA class improved in 38% (n = 129) ivabradine-treated patients with severe HF versus 29% (n = 104) placebo-treated patients (p = 0.009). In the 272 patients with severe HF and baseline heart rate ≥75 beats/min (the indication approved by the European Medicines Agency), ivabradine reduced the primary end point by 25% (p = 0.045), HF hospitalization by 30% (p = 0.042), and cardiovascular death by 32% (p = 0.034). Ivabradine's safety profile in severe HF was indistinguishable from less severe. In conclusion, our analysis confirms that heart rate reduction with ivabradine can be safely used in severe HF and may improve clinical outcomes independently of disease severity. © 2014 Elsevier Inc. All rights reserved.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- beta adrenergic receptor blocking agent
- dipeptidyl carboxypeptidase inhibitor
- ivabradine
- placebo
- adult
- aged
- article
- blurred vision
- bradycardia
- cause of death
- controlled study
- disease course
- disease severity
- double blind procedure
- drug efficacy
- drug safety
- female
- heart atrium fibrillation
- heart failure
- heart left ventricle ejection fraction
- heart rate
- hospitalization
- human
- major clinical study
- male
- meta analysis
- middle aged
- patient care
- practice guideline
- priority journal
- randomized controlled trial
- risk reduction
- systolic heart failure
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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