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S ystolic H eart failure treatment with the I f inhibitor ivabradine T rial

S ystolic H eart failure treatment with the I f inhibitor ivabradine T rial. Heart rate at baseline influences the effect of ivabradine on cardiovascular outcomes in chronic heart failure: analysis from the SHIFT study

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S ystolic H eart failure treatment with the I f inhibitor ivabradine T rial

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  1. Systolic Heart failure treatment withthe Ifinhibitor ivabradineTrial Heart rate at baseline influences the effect of ivabradine on cardiovascular outcomes in chronic heart failure: analysis from the SHIFT study Effect of ivabradine on outcomes in patients with chronic heart failure and HR 75 bpm Böhm M, Borer J, Ford I, et al. ClinRes Cardiol. 2013;102(1):11-22 www.shift-study.com

  2. Aim To assess the effect of ivabradine on outcomes in heart failure patients on recommended background therapies with heart rates ≥75 bpmin the SHIFT trial Böhm M, Borer J, Ford I, et al. ClinRes Cardiol. 2013;102(1):11-22 www.shift-study.com

  3. Baseline characteristics Böhm M, Borer J, Ford I, et al. ClinRes Cardiol. 2013;102(1):11-22 www.shift-study.com

  4. Baseline background treatment Böhm M, Borer J, Ford I, et al. ClinRes Cardiol. 2013;102(1):11-22 www.shift-study.com

  5. Effectof ivabradine on primaryoutcome CV death or hospitalization for HF Hazard ratio=0.76 P<0.0001 Placebo 40 30 Ivabradine Patientswithprimary composite end point (%) 20 10 0 0 6 12 18 24 30 Time (months) Böhm M, Borer J, Ford I, et al. ClinRes Cardiol. 2013;102(1):11-22 www.shift-study.com

  6. Effectof ivabradine on cardiovasculardeath Hazard ratio=0.83 P=0.0166 Placebo 30 Patients withcardiovasculardeath (%) 20 Ivabradine 10 0 0 6 12 18 24 30 Time (months) Böhm M, Borer J, Ford I, et al. ClinRes Cardiol. 2013;102(1):11-22 www.shift-study.com

  7. Effectofivabradine on hospitaladmission for worsening heart failure Hazard ratio=0.70 P<0.0001 Placebo 30 20 Ivabradine Patients withcardiovasculardeath (%) 10 0 0 6 12 18 24 30 Time (months) Böhm M, Borer J, Ford I, et al. ClinRes Cardiol. 2013;102(1):11-22 www.shift-study.com

  8. Effectofivabradine on majoroutcomes • 95% CI P Hazard ratio Primary composite end point Cardiovascularmortality HospitalizationforworseningHF Death from HF All-causemortality All-causehospitalization Anycardiovascularhospitalization 0.76 0.68-0.85 0.83 0.71-0.97 0.70 0.61-0.80 0.61 0.46-0.81 0.83 0.72-0.96 0.82 0.75-0.90 0.79 0.71-0.88 <0.0001 0.0166 <0.0001 0.0006 0.0109 <0.0001 <0.0001 0.20 0.40 0.60 0.80 1.00 1.20 Favors ivabradine Favors placebo Böhm M, Borer J, Ford I, et al. ClinRes Cardiol. 2013;102(1):11-22 www.shift-study.com

  9. Effect of ivabradine on outcomes according to HR achieved at 28 days Patients withprimary composite end point (%)  75 bpm 70 to <75 bpm 65 to <70 bpm 60 to <65 bpm <60 bpm 40 30 20 10 0 0 Day 28 6 12 18 24 Time (months) Böhm M, Borer J, Ford I, et al. ClinRes Cardiol. 2013;102(1):11-22 www.shift-study.com

  10. Patients withprimary composite end point (%) Effect of ivabradine on outcomes according to magnitude of HR reduction 40  0 bpm -10 to <0 bpm < -10 bpm 30 20 10 0 0 Day 28 6 12 18 24 Time (months) Böhm M, Borer J, Ford I, et al. ClinRes Cardiol. 2013;102(1):11-22 www.shift-study.com

  11. Conclusions • In HF in sinus rhythm with HR ≥75 bpmheart rate reduction with ivabradine improves outcomes, including all-cause death and cardiovascular death reduces • Ivabradine-associated risk reductions are related to both HR achieved and magnitude of HR reduction • Patients achieving <60 bpm or with >10 bpm reduction have the best prognosis Böhm M, Borer J, Ford I, et al. ClinRes Cardiol. 2013;102(1):11-22 www.shift-study.com

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