SHIFT
Systolic Heart failure treatment with the If inhibitor ivabradine Trial
Doente / População Intervenção / Exposição Comparação Desfecho
In 6,558 patients with HFrEF (EF ≤ 35%) in sinus rhythm with heart rate ≥ 70 bpm, ivabradine reduced cardiovascular death or hospitalisation for worsening heart failure compared with placebo.
N
6558
Desenho
Double-blind placebo-controlled RCT
Desfecho
Composite of cardiovascular death or hospitalisation for worsening heart failure
Relevância
3
Resultado24% with ivabradine vs 29% with placebo (HR 0.82, 95% CI 0.75-0.90; P<0.0001), driven mainly by fewer HF hospitalisations.
Swedberg K, et al. Lancet. 2010;376(9744):875-885. 10.1016/S0140-6736(10)61198-1
Discussão e crítica
Benefit confined to sinus rhythm with heart rate ≥70 bpm, and background beta-blocker doses often submaximal. Established ivabradine for HFrEF with elevated heart rate despite maximally tolerated beta-blockade.