Addressing Major Unmet Needs in Patients with Systolic Heart Failure: The Role of Ivabradine

• Published in: American journal of cardiovascular drugs : drugs, devices, and other interventions devices, and other interventions, 2016-04, Vol.16 (2), p.93-101
• Main Author: Pereira-Barretto, Antonio Carlos
• Format: Article
• Language: English
• Subjects: Cardiology; Medicine; Medicine & Public Health; Pharmacology/Toxicology; Pharmacotherapy; Review; Review Article
• ISSN: 1175-3277; 1179-187X
• DOI: 10.1007/s40256-016-0159-2

We reviewed clinical evidence for the use of ivabradine in systolic heart failure (HF), in which it appears to improve symptoms, improve quality of life, prevent hospitalization, and prolong survival, thereby addressing unmet needs in the management of HF. Ivabradine provides symptomatic benefits in HF on top of standard therapies, in terms of functional parameters and exercise capacity, and there is some evidence that this leads to improvements in quality of life in symptomatic HF patients, who may have dyspnea, altered exercise capacity, and fatigue. The SHIFT trial demonstrated that ivabradine has significant beneficial effects on major outcomes in HF. Ivabradine had a significant effect on pump failure death, which was reduced by 26 % ( p  = 0.014), with no effect on sudden cardiac death. This is an important result since pump failure death is currently the main cause of death in HF, and also because the reductions in mortality obtained with beta-blockers and spironolactone in the last 20 years appear to be mainly due to reduction in sudden death rather than reduction in pump failure death. Ivabradine also has a beneficial effect on hospital admissions (−26 %, p