Evidence map›Paper›PMID 33410280›Full record

ArticleESC heart failure2021

Combination of ivabradine and sacubitril/valsartan in patients with heart failure and reduced ejection fraction.

Ying-Hsiang Lee, Po-Lin Lin, Wei-Ru Chiou, Jin-Long Huang, Wen-Yu Lin, Chia-Te Liao, Fa-Po Chung, Huai-Wen Liang, Chien-Yi Hsu, Hung-Yu Chang

Registry-linked trialOpen access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07341893 (Clinical Study Evaluating Efficacy and Safety Sacubitril-valsartan in Patients With Heart Failure.), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 10% 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.

NCT07341893 nacompletednot on this mapstarted 2025, after this paper: background citation

Clinical Study Evaluating Efficacy and Safety Sacubitril-valsartan in Patients With Heart Failure.

TypeinterventionalSponsorDamanhour UniversityRan2025 to 2026Enrolled60ConditionsHeart FailureArmsSacubitril-valsartan, standard treatment of heart failure
3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Article
  6. Observational
  7. Review
  8. Article
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  11. Observational
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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

10 authors at 8 institutions in 1 country.

Ying-Hsiang LeeCardiovascular Center, MacKay Memorial Hospital, Taipei, Taiwan.
Po-Lin LinDepartment of Medicine, Mackay Medical College, New Taipei, Taiwan.
Wei-Ru ChiouDepartment of Medicine, Mackay Medical College, New Taipei, Taiwan.
Jin-Long HuangCardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan.
Wen-Yu LinDivision of Cardiology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Chia-Te LiaoDivision of Cardiology, Chi-Mei Medical Center, Tainan, Taiwan.
Fa-Po ChungFaculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Huai-Wen LiangDivision of Cardiology, Department of Internal Medicine, E-Da Hospital; I-Shou University, Kaohsiung, Taiwan.
Chien-Yi HsuFaculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Hung-Yu ChangFaculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Mackay Memorial Hospital · TWNational Yang Ming Chiao Tung University · TWChi Mei Medical Center · TWE-Da Hospital · TWMackay Medical University · TWNational Defense Medical Center · TWTaipei Medical University Hospital · TWTaipei Veterans General Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsIvabradine and sacubitril/valsartan are second-line therapies for patients with heart failure and reduced ejection fraction (HFrEF) based on guideline recommendations. We aimed to evaluate the synergistic effects of these two medications. METHODS AND

resultsPatients' data were extracted from a multicentre database between 2016 and 2018. Patients were classified into (1) Simultaneous group: simultaneous prescription of ivabradine and sacubitril/valsartan within 6 weeks; (2A) Sequential group, ivabradine-first: ivabradine was prescribed first, followed by sacubitril/valsartan; and (2B) Sequential group, sacubitril/valsartan-first: sacubitril/valsartan was prescribed first, followed by ivabradine. A total of 464 patients with HFrEF were enrolled. Cardiovascular death and/or unplanned re-hospitalizations for HF were less frequent (28.6% vs. 44.8%, P = 0.01), and the improvement of left ventricular ejection fraction (LVEF) was significantly greater in patients from the Simultaneous group than those from the Sequential group (∆LVEF 12.8 ± 12.9% vs. 9.3 ± 12.6%, P = 0.007). Among Sequential subgroups, the ivabradine-first treatment decreased heart rate and increased systolic blood pressure (SBP) compared with sacubitril/valsartan-first treatment (∆heart rate -9.1 ± 12.9 b.p.m. vs. 2.6 ± 16.0 b.p.m., P < 0.001; ∆SBP 4.6 ± 16.5 mmHg vs. -4.8 ± 17.2 mmHg, P < 0.001), whereas sacubitril/valsartan-first treatment showed a higher degree of LVEF improvement (∆LVEF 3.6 ± 7.8% vs. 0.7 ± 7.7%, P = 0.002) than ivabradine-first treatment. At the end of follow-up, SBP, LVEF, and left ventricular volume were comparable between two Sequential subgroups.

conclusionsAmong patients with HFrEF, simultaneous rather than sequential treatment with sacubitril/valsartan and ivabradine was a better strategy to reduce adverse events and achieve left ventricular reverse remodelling. Ivabradine treatment had a more significant benefit on improving haemodynamic stability, whereas sacubitril/valsartan treatment showed a more significant effect on improving LVEF.

Indexed as

Heart FailureAminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug CombinationsHumansIvabradineStroke VolumeValsartanVentricular Function, LeftAminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug CombinationsIvabradinesacubitril and valsartan sodium hydrate drug combinationValsartanHeart failureIvabradineSacubitril/valsartan

Identifiers

PMID33410280
PMCPMC8006660
OpenAlexW3120572803

What OpenQuestion holds

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Registered trials

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.