Evidence map›Paper›PMID 34327853›Full record

ArticleESC heart failure2021

The association between ivabradine and adverse cardiovascular events in acute decompensated HFrEF patients.

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

Abstract 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. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
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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.

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

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsIvabradine has been used in patients who have chronic heart failure (HF) with reduced ejection fraction (HFrEF) and concomitant sinus heart rate ≥70 bpm. This administration for acute HFrEF remains a concern. This study used a real-world multicentre database to investigate the effects of ivabradine among patients with acute decompensated HFrEF before discharge. METHODS AND

resultsThis study retrospectively identified patients with acute decompensated HFrEF who were administered ivabradine at discharge from two multicentre HF databases. Propensity score matching was performed to adjust for confounders. Cardiovascular mortality, all-cause mortality, and recurrent HF rehospitalization risks were then compared between those with and without ivabradine treatment. After 1:2 propensity score matching, 876 patients (age, 60.7 ± 14.6 years; female, 23.2%; left ventricular ejection fraction, 28.2% ± 7.8%; and heart rate at discharge, 84.3 ± 13.8 bpm) were included in the final analysis, including 292 and 584 patients with and without ivabradine treatment at discharge, respectively. No significant differences were observed in baseline characteristics between the two groups. At 1 year follow-up, patients in the ivabradine group had significantly lower heart rates (77.6 ± 14.7 vs. 81.1 ± 16.3 bpm; P = 0.005) and lower HF severity symptoms (New York Heart Association Functional class, 2.1 ± 0.7 vs. 2.3 ± 0.9; P < 0.001) than those from the non-ivabradine group. Ivabradine users had significantly lower risks of 1 year cardiovascular mortality (5.8 vs. 12.2 per 100-person year; P = 0.003), all-cause mortality (7.2 vs. 14.0 per 100-person year; P = 0.003), and total HF rehospitalization (42.3 vs. 72.6 per 100-person year; P < 0.001) than non-ivabradine users. Following multivariate analysis, the predischarge prescription of ivabradine remained independently associated with lower 1 year all-cause mortality (hazard ratio, 0.45; 95% confidence interval, 0.28-0.74; P = 0.002) and cardiovascular mortality (hazard ratio, 0.41; 95% confidence interval, 0.24-0.72; P = 0.002).

conclusionsThe current study findings suggest that ivabradine treatment is associated with reduced risks of cardiovascular mortality, all-cause mortality, and HF rehospitalization within 1 year among patients with acute decompensated HFrEF in real-world populations.

Indexed as

Heart FailureAgedFemaleHumansIvabradineMaleMiddle AgedRetrospective StudiesStroke VolumeVentricular Function, LeftIvabradineHeart failureHospitalizationIvabradineMortalityReal-world

Identifiers

PMID34327853
PMCPMC8497193

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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.