TY - JOUR
T1 - Early administration of ivabradine in patients admitted for acute decompensated heart failure
AU - Yang, Teng Yao
AU - Tsai, Meng Shu
AU - Jan, Jeng Yu
AU - Chang, Jung Jung
AU - Chung, Chang Ming
AU - Lin, Ming Shyan
AU - Chen, Hui Ming
AU - Lin, Yu Sheng
N1 - Publisher Copyright:
Copyright © 2022 Yang, Tsai, Jan, Chang, Chung, Lin, Chen and Lin.
PY - 2022/11/29
Y1 - 2022/11/29
N2 - Background: Heart rate (HR) control is important in heart failure (HF) patients with reduced ejection fraction, and ivabradine is indicated for patients with chronic HF and sinus rhythm. However, ivabradine is limited in initiation of ivabradine at acute stage of HF. Materials and methods: This multi-institutional retrospective study enrolled 30,639 patients who were admitted for HF from January 01, 2013 to December 31, 2018 at Chang Gung Memorial Hospitals. After applying selection criteria, the eligible patients were divided into ivabradine and non-ivabradine groups according to the initiation of ivabradine at the index hospitalization. HR, clinical outcomes including HF hospitalization, all-cause hospitalization, mortality, the composite of cardiovascular (CV) death or HF hospitalization and newly developed atrial fibrillation, and left ventricular ejection fraction (LVEF) and left atrium size were compared between the ivabradine and non-ivabradine groups after inverse probability of treatment weighting (IPTW) analysis after 12 months. Results: The HR at admission in the ivabradine group (n = 433) was 99.04 ± 20.69/min, compared to 86.99 ± 20.34/min in the non-ivabradine group (n = 9,601). After IPTW, HR was lower in the ivabradine group than that in the non-ivabradine group after 12 months (74.14 ± 8.53 vs. 81.23 ± 16.79 bpm, p = 0.079). However, there were no significant differences in HF hospitalization (HR = 1.02; 95% CI, 0.38–2.79), all-cause hospitalization (HR = 0.95; 95% CI, 0.54–1.68), mortality (HR = 0.87; 95% CI, 0.69–1.08), the composite of CV death or HF hospitalization (HR = 0.87; 95% CI, 0.69–1.08) and newly developed AF between the two groups. In addition, LVEF increased with time in both groups, but there were no significant differences during the observation period. Conclusion: Ivabradine was beneficial in controlling HR when initiated in patients with acute stage of HF, but it did not seem to provide any benefits in reducing HF hospitalization, all-cause hospitalization, and mortality in 1 year after discharge.
AB - Background: Heart rate (HR) control is important in heart failure (HF) patients with reduced ejection fraction, and ivabradine is indicated for patients with chronic HF and sinus rhythm. However, ivabradine is limited in initiation of ivabradine at acute stage of HF. Materials and methods: This multi-institutional retrospective study enrolled 30,639 patients who were admitted for HF from January 01, 2013 to December 31, 2018 at Chang Gung Memorial Hospitals. After applying selection criteria, the eligible patients were divided into ivabradine and non-ivabradine groups according to the initiation of ivabradine at the index hospitalization. HR, clinical outcomes including HF hospitalization, all-cause hospitalization, mortality, the composite of cardiovascular (CV) death or HF hospitalization and newly developed atrial fibrillation, and left ventricular ejection fraction (LVEF) and left atrium size were compared between the ivabradine and non-ivabradine groups after inverse probability of treatment weighting (IPTW) analysis after 12 months. Results: The HR at admission in the ivabradine group (n = 433) was 99.04 ± 20.69/min, compared to 86.99 ± 20.34/min in the non-ivabradine group (n = 9,601). After IPTW, HR was lower in the ivabradine group than that in the non-ivabradine group after 12 months (74.14 ± 8.53 vs. 81.23 ± 16.79 bpm, p = 0.079). However, there were no significant differences in HF hospitalization (HR = 1.02; 95% CI, 0.38–2.79), all-cause hospitalization (HR = 0.95; 95% CI, 0.54–1.68), mortality (HR = 0.87; 95% CI, 0.69–1.08), the composite of CV death or HF hospitalization (HR = 0.87; 95% CI, 0.69–1.08) and newly developed AF between the two groups. In addition, LVEF increased with time in both groups, but there were no significant differences during the observation period. Conclusion: Ivabradine was beneficial in controlling HR when initiated in patients with acute stage of HF, but it did not seem to provide any benefits in reducing HF hospitalization, all-cause hospitalization, and mortality in 1 year after discharge.
KW - acute heart failure
KW - atrial fibrillation
KW - heart failure
KW - heart rate
KW - ivabradine
UR - http://www.scopus.com/inward/record.url?scp=85143890117&partnerID=8YFLogxK
U2 - 10.3389/fcvm.2022.1036418
DO - 10.3389/fcvm.2022.1036418
M3 - 文章
AN - SCOPUS:85143890117
SN - 2297-055X
VL - 9
JO - Frontiers in Cardiovascular Medicine
JF - Frontiers in Cardiovascular Medicine
M1 - 1036418
ER -