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SHIFT TRIAL |
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| Problem | CHF; EF < 35% |
| Format | Double-blinded multi-center RCT |
| Treatment | Ivabradine (5-7.5mg BD) |
| Control | Placebo |
| Population | 6558 patients |
| Inclusion criteria | Symptomatic heart failure and a left-ventricular ejection fraction of 35% or lower Sinus rhythm Heart rate 70 beats per min or higher Had been admitted to hospital for heart failure within the previous year On stable background treatment including a Î_ blocker if tolerated |
| Exclusion criteria | Main exclusion criteria include recent myocardial infarction, ventricular, or atrioventricular pacing that is operative for more than 40% of the day, atrial fibrillation or symptomatic hypotension. |
| Follow-up | Median 22.9 months |
| Primary endpoint | Composite of cardiovascular death or hospital admission for worsening heart failure |
| Secondary endpoint(s) | Composite of CV death or admission for worsening HF in patients at >50% of the target daily dose of a Î_ blocker |
| Details | . |
| Brief summary: | Ivabradine reduced CCF admissions and deaths, especially those with higher HR |
| PAPER: Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. | |
|---|---|
| Date | 11 Sep 2010 |
| Journal | Lancet. 2010 Sep 11;376(9744):875-85. |
| Information | Ivabradine vs. placebo -N.B. Patients all sinus, HR > 70 +- B-blocker -Significant reduction in composite of CV death & HF admission --Mainly due to reductions in HF admissions ---Apparent within 3 months --NNT 26 to prevent 1/yr -In those on >=50% target daily B-blocker dose --Reduced HF admissions --No reductions in mortality -Those with >median HR had high risks of an event & more benefit --See BEAUTIFUL trial -More withdrawals with ivabradine, but fewer serious events than placebo |