著者
Hiroyuki Tsutsui Shin-ichi Momomura Akira Yamashina Hiroaki Shimokawa Yasuki Kihara Yoshihiko Saito Nobuhisa Hagiwara Hiroshi Ito Masafumi Yano Kazuhiro Yamamoto Junya Ako Takayuki Inomata Yasushi Sakata Takashi Tanaka Yasushi Kawasaki on behalf of the J-SHIFT Study Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-19-0227, (Released:2019-08-08)
参考文献数
18
被引用文献数
24 49

Background:Increased heart rate (HR) is an independent risk factor for cardiovascular outcomes in chronic heart failure (HF). Ivabradine, anIfinhibitor, improved outcomes in patients with HF and reduced ejection fraction (HFrEF) in the SHIFT study. We evaluated its efficacy and safety in Japanese HFrEF patients in a randomized, double-blind, placebo-controlled phase III study: the J-SHIFT study. The main objective was to confirm a hazard ratio of <1 in the primary composite endpoint of cardiovascular death or hospital admission for worsening HF.Methods and Results:Patients with NYHA functional class II–IV, left ventricular EF ≤35%, and resting HR ≥75 beats/min in sinus rhythm under optimal medical therapy received ivabradine (n=127) or placebo (n=127). Mean reduction in resting HR was significantly greater in the ivabradine group (15.2 vs. 6.1 beats/min, P<0.0001). However, symptomatic bradycardia did not occur. A total of 26 (20.5%) patients in the ivabradine group and 37 (29.1%) patients in the placebo group had the primary endpoint event (hazard ratio 0.67, 95% CI 0.40–1.11, P=0.1179) during median follow-up of 589 days. Mild phosphenes were reported in 8 (6.3%) patients in the ivabradine group and 4 (3.1%) patients in the placebo group (P=0.3760).Conclusions:The J-SHIFT study supported the efficacy and safety of ivabradine for Japanese HFrEF patients, in accord with the SHIFT study.

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コララン主要試験 【J-SHIFT試験】 LVEFが35%以下、NYHA心機能分類がII~IV度、洞調律下での安静時心拍数が70回/分以上の日本人慢性心不全患者に対して、プラセボと比較して、心血管系死又は心不全悪化による入院を33%有意に低下させた95% CI, 0.40-1.11, P=0.1179)。 https://t.co/yFFphcG6Et
J SHIFT で見てわかるように、イバブラジン入れると血圧上がっていく傾向が見られる(B/C) RASiやβblockerますます増やせる
読まんと… https://t.co/EKmbbPiBXC
【日本人高心拍数HFrEFにイバブラジンは有用?:J-SHIFT/ Circ J】 日本、心拍数≧75拍/分のHFrEF 254例ランダム化、二重盲検:イバブラジン追加で、プラセボに比べ、CV死亡・HF入院HRは0.67 [95%CI 0.40-1.11]。死亡は1.15 [0.45-2.94] 。CV死亡も1.00 [0.36-2.79]。 https://t.co/1XfgLjFzYd https://t.co/vuPMLBh6KR

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