Key result
Ivabradine improves hierarchical cardiovascular outcomes ~23% over placebo in heart failure.
Why the study?
Resting heart rate is a strong predictor of cardiovascular mortality and morbidity in heart failure, and the SHIFT trial showed ivabradine reduced adverse outcomes but conventional analysis methods have limitations in assessing treatment efficacy.
Does ivabradine improve the win ratio for a hierarchical composite of cardiovascular death and heart failure hospitalizations in patients with HFrEF (LVEF ≤35%) and resting heart rate ≥70 bpm?
Does ivabradine improve the win ratio for a hierarchical composite of cardiovascular death and heart failure hospitalizations in patients with HFrEF (LVEF ≤35%) and resting heart rate ≥70 bpm?
Re-analysis of the SHIFT trial using a win ratio approach demonstrates that ivabradine significantly improves the hierarchical composite of fatal and non-fatal heart failure outcomes.
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Abdin et al. (2025) studied Heart failure with reduced ejection fraction (n=6,505). Ivabradine vs. Placebo was evaluated on Hierarchical composite of cardiovascular death and number of heart failure hospitalizations (Win Ratio) (WR 1.23, 95% CI 1.10-1.37, p=<0.001). Ivabradine demonstrated a significant clinical benefit over placebo for the hierarchical composite of cardiovascular death and heart failure hospitalizations, yielding a win ratio of 1.23.
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