s ystolic h eart failure treatment with the i f inhibitor ivabradine t rial
DESCRIPTION
S ystolic H eart failure treatment with the I f inhibitor ivabradine T rial. The effect of heart rate reduction with ivabradine on renal function in patients with chronic heart failure: an analysis from SHIFT. Voors AA et al. Eur J Heart Fail. 2014 Feb 7. [ Epub ahead of print]. - PowerPoint PPT PresentationTRANSCRIPT
The effect of heart rate reduction with ivabradine on renal function in patients with chronic heart failure: an analysis
from SHIFT
Systolic Heart failure treatment with
the If inhibitor ivabradine Trial
www.shift-study.comVoors AA et al. Eur J Heart Fail. 2014 Feb 7. [Epub ahead of print]
Effect of ivabradine on composite of CV death or HF hospitalization
00 6 12 18 24 30
10
20
30
40
50
Pat
ien
ts (
%)
Time (months)
Ivabradine, renal dysfunction
Placebo, renal dysfunction
N at risk
RD (pl) 799 706 612 488 261 95
RD (iva) 780 720 612 489 273 104
NRD (pl) 2293 2119 1847 1551 820 343
NRD (iva) 2288 2166 1963 1662 906 339
Placebo, no renal dysfunction
Ivabradine, no renal dysfunction
] P=0.023
] P <0.001
Voors AA et al. Eur J Heart Fail. 2014 Feb 7. [Epub ahead of print]
Event rate, n (%)Ivabradine Placebo HR P P interaction
Hospitalization for worsening heart failure
eGFR<60 mL/min/1.73 m² 22 27 0.78 0.0170.89
eGFR60 mL/min/1.73 m² 14 18 0.72 <0.001
Heart failure death
eGFR<60 mL/min/1.73 m² 5 6 0.88 0.560.37
eGFR60 mL/min/1.73 m² 2 3 0.68 0.040
Cardiovascular death
eGFR<60 mL/min/1.73 m² 15 16 0.95 0.690.68
eGFR60 mL/min/1.73 m² 10 11 0.89 0.20
Effect of ivabradine on other outcomes
Voors AA et al. Eur J Heart Fail. 2014 Feb 7. [Epub ahead of print]
Months
Placebo
Ivabradine
Cre
atin
ine,
μm
ol/L
140
130
120
110
100
90
80
70
600 5 10 15 20 25 30
Creatinine values over time with ivabradine and placebo
Voors AA et al. Eur J Heart Fail. 2014 Feb 7. [Epub ahead of print]
Conclusions
In a large trial in patients with chronic systolic HF, renal function generally remained stable
However, if renal function worsened, it was strongly associated with an increased risk for events
Baseline heart rate was directly & independently associated with risk of worsening renal function
Treatment with ivabradine had a neutral effect on renal function during 2 years of follow-up
The beneficial prognostic effects and safety of ivabradine were similar in patients with and without renal dysfunction
Voors AA et al. Eur J Heart Fail. 2014 Feb 7. [Epub ahead of print]