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Influence of Cardiovascular and Noncardiovascular Co-morbidities on Outcomes and Treatment Effect of Heart Rate Reduction With Ivabradine in Stable Heart Failure (from the SHIFT Trial)

Böhm, Michael, MD ; Robertson, Michele, BSc ; Ford, Ian, PhD ; Borer, Jeffrey S., MD ; Komajda, Michel, MD ; Kindermann, Ingrid, MD ; Maack, Christoph, MD ; Lainscak, Mitja, MD ; Swedberg, Karl, MD ; Tavazzi, Luigi, MD

The American journal of cardiology, 2015-12, Vol.116 (12), p.1890-1897 [Periódico revisado por pares]

United States: Elsevier Inc

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Título:
Influence of Cardiovascular and Noncardiovascular Co-morbidities on Outcomes and Treatment Effect of Heart Rate Reduction With Ivabradine in Stable Heart Failure (from the SHIFT Trial)
Autor: Böhm, Michael, MD ; Robertson, Michele, BSc ; Ford, Ian, PhD ; Borer, Jeffrey S., MD ; Komajda, Michel, MD ; Kindermann, Ingrid, MD ; Maack, Christoph, MD ; Lainscak, Mitja, MD ; Swedberg, Karl, MD ; Tavazzi, Luigi, MD
Assuntos: Aged ; Benzazepines - therapeutic use ; Cardiology ; Cardiovascular ; Cardiovascular Agents - therapeutic use ; Clinical Medicine ; Comorbidity ; Cyclic Nucleotide-Gated Cation Channels - antagonists & inhibitors ; Double-Blind Method ; Female ; Follow-Up Studies ; Global Health ; Heart attacks ; Heart Failure, Systolic - drug therapy ; Heart Failure, Systolic - epidemiology ; Heart Failure, Systolic - physiopathology ; Heart Rate - drug effects ; Hospitalization ; Humans ; Incidence ; Klinisk medicin ; Male ; Middle Aged ; Mortality ; Myocardial Infarction - epidemiology ; Pulmonary Disease, Chronic Obstructive - epidemiology ; Survival Rate - trends ; Treatment Outcome
É parte de: The American journal of cardiology, 2015-12, Vol.116 (12), p.1890-1897
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-News-2
ObjectType-Feature-3
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Descrição: Incidence of chronic heart failure (HF) increases with age and cardiovascular (CV) morbidity. Co-morbidities increase hospitalization and mortality in HF, and non-CV co-morbidities may lead to preventable hospitalizations. We studied the impact of co-morbidities on mortality and morbidity in Systolic Heart Failure Treatment with the If Inhibitor Ivabradine Trial, and investigated whether the impact of ivabradine was affected by co-morbidities. We analyzed the Systolic Heart Failure Treatment with the If Inhibitor Ivabradine Trialpopulation, with moderate-to-severe HF and left ventricular dysfunction (in sinus rhythm with heart rate at rest ≥70 beats/min), according to co-morbidity: chronic obstructive pulmonary disease, diabetes mellitus, anemia, stroke, impaired renal function, myocardial infarction, hypertension, and peripheral artery disease. Co-morbidity load was classed as 0, 1, 2, 3, 4+ or 1 to 2 co-morbidities, or 3+ co-morbidities. Co-morbidities were evenly distributed between the placebo and ivabradine groups. Patients with more co-morbidities were likely to be older, women, had more advanced HF, were less likely to be on β blockers, with an even distribution on ivabradine 2.5, 5, or 7.5 mg bid and placebo at all co-morbidity loads. Number of co-morbidities was related to outcomes. Cardiovascular death or HF hospitalization events significantly increased (p <0.0001) with co-morbidity load, with the most events in patients with >3 co-morbidities for both, ivabradine and placebo. There was no interaction between co-morbidity load and the treatment effects of ivabradine. Hospitalization rate was lower at all co-morbidity loads for ivabradine. In conclusion, cardiac and noncardiac co-morbidities significantly affect CV outcomes, particularly if there are >3 co-morbidities. The effect of heart rate reduction with ivabradine is maintained at all co-morbidity loads.
Editor: United States: Elsevier Inc
Idioma: Inglês

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Influence of Cardiovascular and Noncardiovascular Co-morbidities on Outcomes and Treatment Effect of Heart Rate Reduction With Ivabradine in Stable Heart Failure (from the SHIFT Trial)

Böhm, Michael, MD ; Robertson, Michele, BSc ; Ford, Ian, PhD ; Borer, Jeffrey S., MD ; Komajda, Michel, MD ; Kindermann, Ingrid, MD ; Maack, Christoph, MD ; Lainscak, Mitja, MD ; Swedberg, Karl, MD ; Tavazzi, Luigi, MD

United States: Elsevier Inc

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