Does Ivabradine Decrease Cardiovascular Deaths in Heart Failure Patients? - 26/02/20
, Dan Atar, MD b, Victor Serebruany, MD, PhD cAbstract |
Background |
Ivabradine, a heart rate-slowing drug used to treat heart failure and (in Europe) angina, had varying impacts upon cardiovascular events in its 3 large outcome trials. Food and Drug Administration (FDA) analyses may explain the reasons for the variability.
Methods |
An FDA reviewer analyzed the raw data from the 3 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 = .007). This favorable effect is supported by similar interactions in the other 2 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.
Le texte complet de cet article est disponible en PDF.Keywords : Cardiovascular mortality, Drug interaction, Heart failure, Ivabradine, Loop diuretics
Plan
| Funding: None. |
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| Conflict of Interest: None. |
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| Authorship: All authors had access to the data in the US Food and Drug Administration review and a role in writing the manuscript. |
Vol 133 - N° 3
P. 347-351 - mars 2020 Retour au numéro
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