1. 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 Feb 7. [Epub ahead of print]

2. Effect of ivabradine on composite of CV death or HF hospitalization6 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 Feb 7. [Epub ahead of print]

3. 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 Feb 7. [Epub ahead of print]

4. 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 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 Feb 7. [Epub ahead of print]