作者
L Tavazzi, K Swedberg, M Komajda, M Böhm, JS Borer, M Lainscak, M Robertson, I Ford, SHIFT Investigators
发表日期
2013/12/10
期刊
International journal of cardiology
卷号
170
期号
2
页码范围
182-188
出版商
Elsevier
简介
Background
Heart failure (HF) and chronic obstructive pulmonary disease (COPD) frequently coexist, with undefined prognostic and therapeutic implications. We investigated clinical profile and outcomes of patients with chronic HF and COPD, notably the efficacy and safety of ivabradine, a heart rate-reducing agent.
Methods
6505 ambulatory patients, in sinus rhythm, heart rate ≥ 70 bpm and stable systolic HF were randomised to placebo or ivabradine (2.5 to 7.5 mg bid). Multivariate Cox model analyses were performed to compare the COPD (n = 730) and non-COPD subgroups, and the ivabradine and placebo treatment effects.
Results
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. The primary endpoint (PEP) and its component, hospitalisation for worsening HF, were more frequent in COPD patients (HRs f, 1.22 [p …
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