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Research Article| Volume 240, P258-264, August 01, 2017

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Long-term treatment with ivabradine over 12months in patients with chronic heart failure in clinical practice: Effect on symptoms, quality of life and hospitalizations

  • Author Footnotes
    1 The authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    C. Zugck
    Correspondence
    Corresponding author at: Outpatient Clinic for Internal Medicine, Steiner Thor, Bahnhofstr. 1, 94315 Straubing, Germany.
    Footnotes
    1 The authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Outpatient Clinic for Internal Medicine, Steiner Thor, Straubing, Germany
    Search for articles by this author
  • Author Footnotes
    1 The authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    S. Störk
    Footnotes
    1 The authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Comprehensive Heart Failure Center, University Hospital Würzburg, Germany
    Search for articles by this author
  • Author Footnotes
    1 The authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    G. Stöckl
    Footnotes
    1 The authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Department of Medical Affairs, Servier Deutschland GmbH, Munich, Germany
    Search for articles by this author
  • on behalf of theRELIf-CHF study investigators
  • Author Footnotes
    1 The authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
Published:April 11, 2017DOI:https://doi.org/10.1016/j.ijcard.2017.03.131
Long-term treatment with ivabradine over 12months in patients with chronic heart failure in clinical practice: Effect on symptoms, quality of life and hospitalizations
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      Abstract

      Background

      Ivabradine is indicated to control heart rate in otherwise optimally treated patients with chronic heart failure (CHF) and reduced ejection fraction. However, data on its effectiveness outside clinical trials and longer-term effects are scarce.

      Methods

      We performed a prospective cohort study involving 249 German resident cardiologists and analyzed the 1-year effectiveness and safety of ivabradine used in CHF outpatients. Data on symptoms, quality of life, and hospitalizations were collected.

      Results

      In total, 767 CHF patients were enrolled to receive ivabradine twice daily, of whom 684 (90%) were still on ivabradine at study end (mean treatment duration 11.2 months). The cohort was representative of CHF patients seen in clinical practice in terms of age, risk factor profile, and comorbidities. Concomitant beta-blocker therapy was prescribed in 497 patients (65%). After one year, compared to baseline, heart rate in ivabradine-treated patients was 16 bpm lower. This reduction was associated with a significant improvement in NYHA class, and less frequent signs of decompensation (36% to 8%). The proportion of hospitalized patients within 1 year decreased from 23% before treatment, to 5% with ivabradine therapy. These improvements in clinical status were accompanied by a reduction in BNP and an increase in LVEF (+5.1% at 1 year). Quality of life was significantly improved in all measured dimensions. Adverse drug reactions were noted in 26 patients (3%), and were in line with the known safety profile of ivabradine.

      Conclusions

      Ivabradine was effective and well-tolerated in CHF patients seen in clinical practice throughout 1 year of treatment.

      Keywords

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      Article info

      Publication history

      Published online: April 11, 2017
      Accepted: March 28, 2017
      Received: January 5, 2017

      Identification

      DOI: https://doi.org/10.1016/j.ijcard.2017.03.131

      Copyright

      © 2017 Published by Elsevier Ireland Ltd.

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