Evidence map›Paper›PMID 22575988›Full record

Trial reportClinical research in cardiology : official journal of the German Cardiac Society2013

Heart rate at baseline influences the effect of ivabradine on cardiovascular outcomes in chronic heart failure: analysis from the SHIFT study.

Michael Böhm, Jeffrey Borer, Ian Ford, Jose R Gonzalez-Juanatey, Michel Komajda, Jose Lopez-Sendon, Jan-Christian Reil, Karl Swedberg, Luigi Tavazzi

Open access · greenAbstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Clinical research in cardiology : official journal of the German Cardiac Society, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 82 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
82citing papers in PubMed, 2 pooled it
13.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

82 citing papers in PubMed, 2 syntheses or guidelines pooled it, 247 citations in OpenAlex.

  1. Ivabradine as adjuvant treatment for chronic heart failure.The Cochrane database of systematic reviews · 2020
    Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Impact of eplerenone on major cardiovascular outcomes in patients with systolic heart failure according to baseline heart rate.Clinical research in cardiology : official journal of the German Cardiac Society · 2019
    Trial
  6. Trial
  7. Trial
  8. Trial
  9. Review
  10. Review
  11. Article
  12. Review
  13. Article
  14. Article
  15. Review
  16. Review
  17. Article
  18. Article
  19. Observational
  20. Review

22 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 8 institutions in 7 countries.

Michael BöhmKlinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Str. 1, 66424, Homburg/Saar, Germany. michael.boehm@uks.eu
Jeffrey Borer
Ian Ford
Jose R Gonzalez-Juanatey
Michel Komajda
Jose Lopez-Sendon
Jan-Christian Reil
Karl Swedberg
Luigi Tavazzi
Universitätsklinikum des Saarlandes · DEMaria Cecilia Hospital · ITPitié-Salpêtrière Hospital · FRSUNY Downstate Health Sciences University · USUniversidad Autónoma de Madrid · ESUniversidade de Santiago de Compostela · ESUniversity of Glasgow · GBUniversity of Gothenburg · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe analysed the effect of ivabradine on outcomes in heart failure (HF) patients on recommended background therapies with heart rates ≥75 bpm and <75 bpm in the SHIFT trial. A cut-off value of ≥75 bpm was chosen by the EMEA for approval for the use of ivabradine in chronic heart failure.

methodsThe SHIFT population was divided by baseline heart rate ≥75 or <75 bpm. The effect of ivabradine was analysed for primary composite endpoint (cardiovascular death or HF hospitalization) and other endpoints.

resultsIn the ≥75 bpm group, ivabradine reduced primary endpoint (HR 0.76, 95 % CI 0.68-0.85, P < 0.0001), all-cause mortality (HR 0.83, 95 % CI, 0.72-0.96, P = 0.0109), cardiovascular mortality (HR 0.83, 95 % CI, (0.71-0.97, P = 0.0166), HF death (HR 0.61, 95 % CI, 0.46-0.81, P < 0.0006), and HF hospitalization (HR 0.70, 95 % CI, 0.61-0.80, P < 0.0001). Risk reduction depended on heart rate after 28 days, with the best protection for heart rates <60 bpm or reductions >10 bpm. None of the endpoints was significantly reduced in the <75 bpm group, though there were trends for risk reductions in HF death and hospitalization for heart rate <60 bpm and reductions >10 bpm. Ivabradine was tolerated similarly in both groups.

conclusionThe effect of ivabradine on outcomes is greater in patients with heart rate ≥75 bpm with heart rates achieved <60 bpm or heart rate reductions >10 bpm predicting best risk reduction. Our findings emphasize the importance of identification of high-risk HF patients by high heart rates and their treatment with heart rate-lowering drugs such as ivabradine.

Indexed as

Heart RateAgedAnti-Arrhythmia AgentsBenzazepinesChronic DiseaseDisease ProgressionDouble-Blind MethodFemaleHeart FailureHospitalizationHumansIvabradineKaplan-Meier EstimateMaleMiddle AgedPatient SelectionAnti-Arrhythmia AgentsBenzazepinesIvabradine

Identifiers

PMID22575988
OpenAlexW2045247934

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.