Key result
Left bundle branch block in systolic heart failure was associated with a 65% increase in cardiovascular death or heart failure hospitalization (P<0.001), with no interaction by heart rate.
Why the study?
Does ivabradine reduce cardiovascular death or heart failure hospitalization in systolic heart failure patients with left bundle branch block?
Population
6,505 patients with systolic heart failure in sinus rhythm with heart rates ≥70 b.p.m. from the SHIFT trial…
Design
Cohort
Authors
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LBBB identifies higher-risk systolic HF independent of heart rate; leaves open ivabradine benefit in this subgroup.
Cohort (n=6,505)
Does ivabradine reduce cardiovascular death or heart failure hospitalization in systolic heart failure patients with left bundle branch block?
Effect estimate: 65% increase
p-value: p=<0.001
Left bundle branch block independently increases the risk of adverse outcomes in systolic heart failure patients, and ivabradine appears safe and directionally beneficial in this subgroup despite a lack of statistical power.
Reil et al. (2013) conducted a cohort in Chronic Heart Failure (n=6,505). Ivabradine vs. No LBBB was evaluated on Cardiovascular death or HF hospitalization (65% increase, p=<0.001). Left bundle branch block in systolic heart failure was associated with a 65% increase in cardiovascular death or heart failure hospitalization (P<0.001), with no interaction by heart rate.
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