The effect of heart rate reduction with ivabradine on renal function in patients with chronic heart failure: an analysis from SHIFT Systolic Heart failure.

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Presentation transcript:

The effect of heart rate reduction with ivabradine on renal function in patients with chronic heart failure: an analysis from SHIFT Systolic Heart failure treatment with the I f inhibitor ivabradine Trial Voors AA et al. Eur J Heart Fail Feb 7. [Epub ahead of print]

Effect of ivabradine on composite of CV death or HF hospitalization Patients (%) Time (months) Ivabradine, renal dysfunction Placebo, renal dysfunction N at risk RD (pl) RD (iva) NRD (pl) NRD (iva) Placebo, no renal dysfunction Ivabradine, no renal dysfunction ] P=0.023 ] P <0.001 Voors AA et al. Eur J Heart Fail Feb 7. [Epub ahead of print]

Event rate, n (%) Ivabradine Placebo HRPP interaction Hospitalization for worsening heart failure eGFR<60 mL/min/1.73 m² eGFR  60 mL/min/1.73 m² <0.001 Heart failure death eGFR<60 mL/min/1.73 m² eGFR  60 mL/min/1.73 m² Cardiovascular death eGFR<60 mL/min/1.73 m² eGFR  60 mL/min/1.73 m² Effect of ivabradine on other outcomes Voors AA et al. Eur J Heart Fail Feb 7. [Epub ahead of print]

Months Placebo Ivabradine Creatinine values over time with ivabradine and placebo Voors AA et al. Eur J Heart Fail Feb 7. [Epub ahead of print]

Conclusions  In a large trial in patients with chronic systolic HF, renal function generally remained stable  However, if renal function worsened, it was strongly associated with an increased risk for events  Baseline heart rate was directly & independently associated with risk of worsening renal function  Treatment with ivabradine had a neutral effect on renal function during 2 years of follow-up  The beneficial prognostic effects and safety of ivabradine were similar in patients with and without renal dysfunction Voors AA et al. Eur J Heart Fail Feb 7. [Epub ahead of print]