Systolic Heart failure treatment with the If inhibitor ivabradine Trial The effect of heart rate reduction with ivabradine on renal function in patients.

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S ystolic H eart failure treatment with the I f inhibitor ivabradine T rial Efficacy and safety of ivabradine in patients with chronic systolic heart failure.

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Systolic Heart failure treatment with the If inhibitor ivabradine Trial The effect of heart rate reduction with ivabradine on renal function in patients with chronic heart failure: an analysis from SHIFT Voors AA et al. Eur J Heart Fail. 2014 Feb 7. [Epub ahead of print] www.shift-study.com

Effect of ivabradine on composite of CV death or HF hospitalization 6 12 18 24 30 10 20 40 50 Patients (%) Time (months) Ivabradine, renal dysfunction Placebo, renal dysfunction ] P=0.023 Placebo, no renal dysfunction ] P <0.001 Ivabradine, no renal dysfunction N at risk RD (pl) 799 706 612 488 261 95 RD (iva) 780 720 489 273 104 NRD (pl) 2293 2119 1847 1551 820 343 NRD (iva) 2288 2166 1963 1662 906 339 Voors AA et al. Eur J Heart Fail. 2014 Feb 7. [Epub ahead of print]

Effect of ivabradine on other outcomes Event rate, n (%) Ivabradine Placebo HR P P interaction Hospitalization for worsening heart failure eGFR<60 mL/min/1.73 m² 22 27 0.78 0.017 0.51 eGFR60 mL/min/1.73 m² 14 18 0.72 <0.001 Heart failure death 5 6 0.88 0.56 0.37 2 3 0.68 0.040 Cardiovascular death 15 16 0.95 0.69 10 11 0.89 0.20 Voors AA et al. Eur J Heart Fail. 2014 Feb 7. [Epub ahead of print]

Creatinine values over time with ivabradine and placebo Creatinine, μmol/L 140 130 120 110 100 90 80 70 60 5 10 15 20 25 30 Placebo Ivabradine Months Voors AA et al. Eur J Heart Fail. 2014 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. 2014 Feb 7. [Epub ahead of print]