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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. Effects on outcomes of heart rate r eduction by i vabradine in patients w ith congestive h eart f ailure : i s there an influence of beta-blocker d ose ?.

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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 ivabradine Trial Effects on outcomes of heart rate reduction by ivabradinein patients with congestive heart failure: is there an influence of beta-blocker dose? Swedberg K, et al. J Am CollCardiol.2012; 59:1938-1945 www.shift-study.com

  2. Clinical characteristics of patients by β-blocker status Swedberg K, et al. J Am CollCardiol.2012; 59:1938-1945 www.shift-study.com

  3. Effect of ivabradine on outcomes by β-blocker doses **adjusted for interaction between baseline HR and randomisedtreatment Swedberg K, et al. J Am CollCardiol.2012; 59:1938-1945 www.shift-study.com

  4. HR reduction according toβ-blocker and HR category HR reduction(bpm) frombaselineto 28 dayswithivabradine* • Baseline • HRcategory (bpm) • ≥87 • 80 to <87 • 75 to <80 • 72 to <75 Impact of baselineHR on HRreductionwith ivabradine • <72 • No BB • BB<25% • BB 25-50% • BB50-100% • BB ≥100% • β-blockercategory No impact of BB dose on HRreductionwith ivabradine *Placebo corrected Swedberg K, et al. J Am CollCardiol.2012; 59:1938-1945 www.shift-study.com

  5. Conclusion • In patients with systolic HF treated with guideline-recommended therapies, resting HR remains an important modifiable risk factor in patients treated with β-blockers • When HR ≥70 bpm, reduction of heart rate with ivabradine will provide additional clinical benefits regardless of the ß-blocker dose • The magnitude of HR reduction with ivabradine, beyond that achieved by β-blockers, primarily determines subsequent outcome www.shift-study.com Swedberg K, et al. J Am CollCardiol.2012; 59:1938-1945

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