Effect of ivabradine in patients with heart failure with preserved ejection fraction
| Jazyk: | angličtina |
|---|---|
| Rok vydání: | 2017 |
| Předmět: | |
| Zdroj: | European Journal of Heart Failure. 19(11):1495-1503 |
| ISSN: | 1879-0844 1388-9842 |
| DOI: | 10.1002/ejhf.876 |
| Popis: | Aims This randomized, double-blind, placebo-controlled trial assessed whether heart rate (HR) reduction with ivabradine improves cardiac function in heart failure with preserved ejection fraction (HFpEF).Methods and results The prEserveD left ventricular ejectIon fraction chronic heart Failure with ivabradine studY (EDIFY) included 179 patients in New York Heart Association (NYHA) classes II and III, in sinus rhythm, with HR of >= 70 b.p.m., NT-proBNP of >= 220 pg/mL (BNP >= 80 pg/mL) and left ventricular ejection fraction of >= 45%. Ivabradine (or placebo) was titrated to 7.5 mg b.i.d. Patients were followed for 8 months on the change and assessed for three co-primary endpoints: echo-Doppler E/e' ratio, distance on the 6-min walking test (6MWT), and plasma NT-proBNP concentration. At baseline, median E/e' was 12.8 [interquartile range (IQR): 9.9-16.3], median distance on the 6MWT was 320m (IQR: 247-375 m), and median NT-proBNP was 375 pg/mL (IQR: 253-701 pg/mL). Baseline median HR was 75 b. p. m. (IQR: 70-107 b. p. m.). A total of 171 patients (87 in the ivabradine group, 84 in the placebo group) were evaluated for treatment efficacy. After 8months of treatment, findings showed a median change in HR of -13.0 b. p. m. (IQR: -18.0 to -6.0 b. p. m.) in the ivabradine group and -3.5 b. p. m. (IQR: -11.5 to 3.0 b. p. m.) in the placebo group [estimated between-group difference: 7.7 b. p. m.; 90% confidence interval (CI) -10 to -5.4; P Conclusions In patients with HFpEF, HR reduction with ivabradine did not improve outcomes. These findings do not support the use of ivabradine in HFpEF. |
| Databáze: | OpenAIRE |
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