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Does Ivabradine Decrease Cardiovascular Deaths in Heart Failure Patients?
Am J Med. 2019 Aug 20;:
Authors: Marciniak TA, Atar D, Serebruany V
Abstract
BACKGROUND: Ivabradine, a heart rate slowing drug used to treat heart failure and (in Europe) angina, had varying impacts upon cardiovascular events in its three large outcome trials. FDA analyses may explain the reasons for the variability.
METHODS: An FDA reviewer analyzed the raw data from the three trials using logistic regressions to assess interactions between ivabradine and other drugs and forest plots to display dose responses.
RESULTS: Ivabradine in its SHIFT heart failure trial shows a significant interaction with loop diuretics with a beneficial impact upon cardiovascular deaths (odds ratio 0.61, 95% confidence interval 0.42 - 0.87, p = 0.007). This favorable effect is supported by similar interactions in the other two trials (BEAUTIFUL, SIGNIFY) and by a dose response for loop diuretics interacting with ivabradine in the SHIFT and BEAUTIFUL trials. The interaction is not related to heart failure severity.
CONCLUSION: Ivabradine used concomitantly with a loop diuretic has a beneficial impact upon cardiovascular death.
PMID: 31442391 [PubMed - as supplied by publisher]