PMID- 24332674
OWN - NLM
STAT- MEDLINE
DCOM- 20140318
LR  - 20181203
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 113
IP  - 3
DP  - 2014 Feb 1
TI  - Efficacy and safety of ivabradine in patients with severe chronic systolic heart 
      failure (from the SHIFT study).
PG  - 497-503
LID - S0002-9149(13)02163-2 [pii]
LID - 10.1016/j.amjcard.2013.10.033 [doi]
AB  - A post hoc analysis of Systolic Heart failure treatment with the If 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.
CI  - Copyright (c) 2014 Elsevier Inc. All rights reserved.
FAU - Borer, Jeffrey S
AU  - Borer JS
AD  - Division of Cardiovascular Medicine, The Howard Gilman Institute for Heart Valve 
      Disease and the Schiavone Institute for Cardiovascular Translational Research, 
      State University of New York Downstate Medical Center, New York, New York. 
      Electronic address: canadad45@aol.com.
FAU - Bohm, Michael
AU  - Bohm M
AD  - Klinik fur Innere Medizin III, Universitatskliniken des Saarlandes, Homburg, 
      Saar, Germany.
FAU - Ford, Ian
AU  - Ford I
AD  - Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United 
      Kingdom.
FAU - Robertson, Michele
AU  - Robertson M
AD  - Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United 
      Kingdom.
FAU - Komajda, Michel
AU  - Komajda M
AD  - Department of Cardiology, Pierre et Marie Curie Paris VI University, La 
      Pitie-Salpetriere Hospital, Paris, France.
FAU - Tavazzi, Luigi
AU  - Tavazzi L
AD  - Maria Cecilia Hospital, Gruppo Villa Maria Care and Research, Ettore Sansavini 
      Health Science Foundation, Cotignola, Italy.
FAU - Swedberg, Karl
AU  - Swedberg K
AD  - Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of 
      Gothenburg, Goteborg, Sweden.
CN  - SHIFT Investigators
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20131109
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Benzazepines)
RN  - 0 (Cyclic Nucleotide-Gated Cation Channels)
RN  - 3H48L0LPZQ (Ivabradine)
SB  - IM
MH  - Benzazepines/*administration & dosage
MH  - Cyclic Nucleotide-Gated Cation Channels
MH  - Disease Progression
MH  - Dose-Response Relationship, Drug
MH  - Double-Blind Method
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure, Systolic/*drug therapy/physiopathology
MH  - Humans
MH  - Ivabradine
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Prospective Studies
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - Ventricular Function, Left/*drug effects
EDAT- 2013/12/18 06:00
MHDA- 2014/03/19 06:00
CRDT- 2013/12/17 06:00
PHST- 2013/08/06 00:00 [received]
PHST- 2013/10/09 00:00 [revised]
PHST- 2013/10/09 00:00 [accepted]
PHST- 2013/12/17 06:00 [entrez]
PHST- 2013/12/18 06:00 [pubmed]
PHST- 2014/03/19 06:00 [medline]
AID - S0002-9149(13)02163-2 [pii]
AID - 10.1016/j.amjcard.2013.10.033 [doi]
PST - ppublish
SO  - Am J Cardiol. 2014 Feb 1;113(3):497-503. doi: 10.1016/j.amjcard.2013.10.033. Epub 
      2013 Nov 9.