Published in February 2014
A recent analysis from SHIFT explored the efficacy and safety of ivabradine in 712 patients with severe heart failure (LVEF ≤20% and/or NYHA class IV) and 5973 with less severe heart failure (NYHA classes II/III and LVEF >20%). Treatment with ivabradine in severe heart failure was associated with relative risk reductions indistinguishable from those of less severe disease for the primary end point (16% reduction), all-cause death (22%), cardiovascular death (22%), heart failure death (37%), and heart failure hospitalization (17%) (all P for interaction nonsignificant). Moreover, in the 272 patients with severe heart failure and baseline heart rate ≥75 bpm (the indication approved by the EMA), ivabradine reduced the primary end point by 25% (P=0.045), heart failure hospitalization by 30% (P=0.042), and cardiovascular death by 32% (P=0.034). Ivabradine’s safety profile in severe heart failure was indistinguishable from that in less severe heart failure. Ivabradine can be safely used in severe heart failure and improves clinical outcomes, independently of heart failure severity.1

1. Borer JS, Böhm M, Ford I at al. SHIFT Investigators. Efficacy and Safety of Ivabradine in Patients With Severe Chronic Systolic Heart Failure (from the SHIFT Study). Am J Cardiol. 2014;113(3):497-503.