Real-World Effectiveness of Ivabradine in Chinese Patients with Chronic Heart Failure: Interim Analysis of the POSITIVE Study

Am J Cardiovasc Drugs. 2022 May;22(3):345-354. doi: 10.1007/s40256-021-00500-x. Epub 2021 Dec 8.

Abstract

Background: Ivabradine improves cardiac function and clinical outcomes in chronic heart failure (HF) by reducing heart rate (HR), but there is a lack of real-world data on its effectiveness and safety in Chinese patients.

Methods: We designed a prospective, multicenter, observational study of Chinese adults with HF and left ventricular systolic dysfunction, resting HR ≥ 75 beats per minute (bpm), and an indication for ivabradine treatment. An interim analysis was performed using a cut-off date of 31 October 2019. The primary outcome was change in HR at 6 months after the initiation of ivabradine. Secondary endpoints included change in New York Heart Association (NYHA) functional class; quality of life (QoL), measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ); and adverse events (AEs).

Results: Overall, 655 subjects were included in the interim analysis. Mean reduction in HR from baseline was 13.2 (95% confidence interval [CI] 11.2-15.2) bpm at Month 1, and 14.5 (95% CI 11.8-17.2) bpm at Month 6 (p < 0.001 for both changes). NYHA functional class and KCCQ scores improved significantly over time (p < 0.001 for all comparisons with baseline), indicating amelioration of symptoms and better QoL, respectively. Forty-four subjects (6.7%) reported a total of 60 ivabradine-related AEs, most frequently phosphenes and bradycardia (both n = 6, 0.9%).

Conclusion: Treatment with ivabradine for 6 months effectively reduced HR and improved functional class and QoL in Chinese patients with chronic HF. Treatment was well tolerated.

Clinical trial registration: ISRCTN11703380; registered on 8 November 2016.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Benzazepines / adverse effects
  • Cardiovascular Agents* / adverse effects
  • China
  • Chronic Disease
  • Heart Failure*
  • Heart Rate
  • Humans
  • Ivabradine / pharmacology
  • Ivabradine / therapeutic use
  • Prospective Studies
  • Quality of Life
  • Treatment Outcome
  • Ventricular Function, Left

Substances

  • Benzazepines
  • Cardiovascular Agents
  • Ivabradine

Associated data

  • ISRCTN/ISRCTN11703380