1. 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 www.shift-study.com Voors AA et al. Eur J Heart Fail. 2014 Feb 7. [Epub ahead of print]

2. Effect of ivabradine on composite of CV death or HF hospitalization 0 0612182430 10 20 30 40 50 Patients (%) Time (months) Ivabradine, renal dysfunction Placebo, renal dysfunction N at risk RD (pl)79970661248826195 RD (iva)780720612489273104 NRD (pl)2293211918471551820343 NRD (iva)2288216619631662906339 Placebo, no renal dysfunction Ivabradine, no renal dysfunction ] P=0.023 ] P <0.001 Voors AA et al. Eur J Heart Fail. 2014 Feb 7. [Epub ahead of print]

3. Event rate, n (%) Ivabradine Placebo HRPP interaction Hospitalization for worsening heart failure eGFR<60 mL/min/1.73 m² 22270.780.017 0.89 eGFR  60 mL/min/1.73 m² 14180.72<0.001 Heart failure death eGFR<60 mL/min/1.73 m² 560.880.56 0.37 eGFR  60 mL/min/1.73 m² 230.680.040 Cardiovascular death eGFR<60 mL/min/1.73 m² 15160.950.69 0.68 eGFR  60 mL/min/1.73 m² 10110.890.20 Effect of ivabradine on other outcomes Voors AA et al. Eur J Heart Fail. 2014 Feb 7. [Epub ahead of print]

4. Months Placebo Ivabradine Creatinine values over time with ivabradine and placebo Voors AA et al. Eur J Heart Fail. 2014 Feb 7. [Epub ahead of print]

5. 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. 2014 Feb 7. [Epub ahead of print]