Heart failure & cardiomyopathiesSecondary analysis
Time to Benefit of Heart Rate Reduction with Ivabradine in Patients with Heart Failure and Reduced Ejection Fraction
- Post-hoc analysis of the SHIFT randomised trial
Authors' conclusion
At HR ≥75 bpm, the time to risk reduction was shorter for reduction of hospitalization and mortality outcomes in patients with HFrEF after initiation of guideline-directed medication, including beta-blockers at maximally tolerated doses.
Study context
- Population
- Patients with HF and reduced ejection fraction (HFrEF) in sinus rhythm with HR ≥70 bpm (overall) and baseline HR ≥75 bpm
- Comparison
- Ivabradine vs placebo
- Primary endpoint
- Time to statistically significant reduction of the primary outcome (HF hospitalization and CV death), its components, all-cause death and HF death
Primary result
As reported in the abstract
Time to significant reduction vs placebo
- HR ≥70 bpm: primary outcome significantly reduced
- 102 days
- HR ≥70 bpm: Heart failure (HF) hospitalizations significantly reduced
- 102 days
- HR ≥75 bpm: primary outcome reduced
- 67 days
- HR ≥75 bpm: HF hospitalization reduced
- 78 days
- HR ≥75 bpm: CV death reduced
- 169 days
- HR ≥75 bpm: HF death reduced
- 157 days
- HR ≥75 bpm: all-cause death reduced
- 169 days
Original publication
Time to Benefit of Heart Rate Reduction with Ivabradine in Patients with Heart Failure and Reduced Ejection Fraction. Eur J Heart Fail. Published 15 May 2023. doi:10.1002/ejhf.2870
Summarised from the published abstract; every number is checked against it