Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study

Abstract (PubMed)

Chronic heart failure is associated with high mortality and morbidity. Raised resting heart rate is a risk factor for adverse outcomes. We assessed the effect of heart-rate reduction by the selective sinus-node inhibitor ivabradine on outcomes in heart failure. In this randomised, double-blind, placebo-controlled, parallel-group study, 6558 patients with symptomatic heart failure and LVEF ≤35%, sinus rhythm with HR ≥70 bpm, and hospitalisation for HF within the previous year were randomised to ivabradine (max 7.5 mg twice daily) or placebo. The primary endpoint was cardiovascular death or hospital admission for worsening heart failure. Ivabradine significantly reduced the primary endpoint (hazard ratio 0.82, 95% CI 0.75-0.90; p<0.0001), driven mainly by hospital admissions for worsening heart failure.