Selective lowering of heart rate reduces risk of death and hospitalization: Study

Study shows lowering heart rate reduces risk of death and hospitalization by more than one quarter - literally a paradigm "SHIFT"

The results of a major international study presented at the European Society of Cardiology Congress in Stockholm and published simultaneously in The Lancet show, for the first time, that selectively lowering heart rate with a novel medication, ivabradine, significantly reduces risk of death and hospitalization for patients with heart failure.  This also resolves a longstanding debate about whether lowering heart rate itself can actually lower the risk of heart disease progression.

The study, called SHIFT, (Systolic Heart Failure Treatment with the I_f Inhibitor Ivabradine Trial) compared a specific heart rate lowering medication, ivabradine, to placebo in addition to standard treatment for heart failure.  The conclusions will change the way patients are managed in the future.

The results show that death from heart failure was reduced significantly - by 26%.

The Canadian portion of this largest ever morbidity-mortality study of treatments for chronic heart failure involving over 6,500 patients from 37 countries, was led by Dr. Peter Liu at the Peter Munk Cardiac Centre, University Health Network. The data from the many centres across Canada that participated in the SHIFT trial were coordinated by the team at the Montreal Heart Institute.

"SHIFT represents a significant milestone in how physicians will treat and manage heart failure in the future. For the first time ever, we have data that confirm that heart rate plays a key role in the progression of heart failure, and this is truly a paradigm "SHIFT" for both physicians and patients," said Dr. Peter Liu, who is also President of the International Society of Cardiomyopathy and Heart Failure of the World Heart Federation, and past Scientific Chair of the Heart Failure Society of America. "Adding a unique selective heart rate lowering drug, ivabradine, to standard therapy early, dramatically reduces the risk of death and hospitalization for heart failure.  This adds an entirely new potential approach to the treatments we have available to deal with this deadly epidemic of heart failure that is already affecting one in five Canadians."

Ivabradine is not yet approved for clinical use in Canada.