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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. Main results. www.shift-study.com. Swedberg K, et al. Lancet . 2010;376(9744):875-885. Primary composite endpoint (CV death or hospital admission for worsening HF). Cumulative frequency (%). 40.

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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 Main results www.shift-study.com Swedberg K, et al. Lancet. 2010;376(9744):875-885

  2. Primary composite endpoint(CV death or hospital admission for worsening HF) Cumulative frequency (%) 40 HR = 0.82 (0.75–0.90) P < 0.0001 Placebo 18% 30 Ivabradine 20 10 0 0 6 12 18 24 30 Months www.shift-study.com Swedberg K, et al. Lancet. 2010;376(9744):875-885

  3. Hospitalization for HF Cumulative frequency (%) 30 Placebo HR =0.74 (0.66–0.83) P < 0.0001 26% 20 Ivabradine 10 0 0 6 12 18 24 30 Months www.shift-study.com Swedberg K, et al. Lancet. 2010;376(9744):875-885

  4. Death from heart failure Cumulative frequency (%) 10 HR = 0.74 (0.58–0.94) P = 0.014 Placebo 26% 5 Ivabradine 0 0 6 12 18 24 30 Months www.shift-study.com Swedberg K, et al. Lancet. 2010;376(9744):875-885

  5. Effect of ivabradineon outcomes www.shift-study.com Swedberg K, et al. Lancet. 2010;376(9744):875-885

  6. Effect of ivabradine in prespecified subgroups Test for interaction Age<65 years≥65 years Sex Male Female Beta-blockers No Yes Aetiology of heartfailure Non-ischaemic Ischaemic NYHA class NYHA class II NYHA class III or IV Diabetes No Yes Hypertension No Yes Baseline heart rate <77 bpm ≥77 bpm P = 0.029 0.5 1.0 1.5 Hazard ratio Favours ivabradine Favours placebo www.shift-study.com Swedberg K, et al. Lancet. 2010;376(9744):875-885

  7. Mean heart rate reduction 70% of patients on ivabradine 7.5 mg bid Heart rate (bpm) 90 80 80 Placebo 75 75 70 67 Ivabradine 64 60 50 0 2 weeks 1 4 8 12 16 20 24 28 32 Months www.shift-study.com Swedberg K, et al. Lancet. 2010;376(9744):875-885

  8. Ivabradine Placebo NYHA class changes Patients (%) 70 68 P = 0.0003 70 60 50 40 28 24 30 20 6 5 10 0 Improvement Stability Worsening www.shift-study.com Swedberg K, et al. Lancet. 2010;376(9744):875-885

  9. Incidence of selected adverse events (n = 6492) www.shift-study.com Swedberg K, et al. Lancet. 2010;376(9744):875-885

  10. Treatment discontinuation www.shift-study.com Swedberg K, et al. Lancet. 2010;376(9744):875-885

  11. Conclusion Ivabradine significantly reduces major risks associated with heart failure: • 18% reduction in CV death or hospital admission for worsening HF • 26% reduction in death from heart failure • 26% reduction in hospital admission for worsening heart failure Benefits are apparent early, are consistent in predefined subgroups, and have been demonstrated on top of recommended therapy Treatment is well tolerated www.shift-study.com Swedberg K, et al. Lancet. 2010;376(9744):875-885

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