Published in December 2013
The presence of chronic obstructive pulmonary disease (COPD) is associated with increased risk of cardiovascular outcomes in patients with chronic heart failure and represents the barrier to optimized heart failure therapy including beta-blockers. This analysis assessed the efficacy and safety of ivabradine in the SHIFT study population with and without COPD. 11% of the SHIFT population had COPD (n=730). COPD patients were older and had a poorer risk profile. Beta-blockers were prescribed to 69% of COPD patients and 92% of non-COPD patients. Ivabradine reduced risk of the primary end point and heart failure hospitalization similarly in both COPD (14%, and 17%) and non-COPD (18% and 27%) patients (P interaction=0.82, and 0.53, respectively). A similar effect was also noted for cardiovascular death. Adverse events were more common in COPD patients, but similar in treatment subgroups. Ivabradine is similarly effective and safe in chronic heart failure patients with or without COPD, and can be safely combined with beta-blockers in COPD.1
1. Tavazzi L, Swedberg K, Komajda M et al. SHIFT Investigators. Clinical profiles and outcomes in patients with chronic heart failure and chronic obstructive pulmonary disease: an efficacy and safety analysis of SHIFT study. Int J Cardiol. 2013;170(2):182-188.