Estudio SHIFT: papel de la ivabradina en la insuficiencia cardiaca y su importancia en la práctica clínica

The Systolic Heart failure treatment with If inhibitor ivabradine Trial (SHIFT) is a case-referent study of a novel approach to the treatment of patients with heart failure. The rationale is that a high heart rate is not only a risk marker for disease but is also a modifiable risk factor that could serve as a therapeutic target in patients with heart failure and depressed systolic function. The study enrolled 6558 patients with chronic heart failure, left ventricular systolic dysfunction (i.e. an ejection fraction ≤35%) and a sinus rhythm of 70 beats/min or higher. It was found that the addition of ivabradine resulted in a reduction in the combined endpoint of cardiovascular death or readmission for heart failure, which was mainly due to a reduction in hospitalization for exacerbations of congestive symptoms. In addition, ivabradine also had an additive effect on ventricular remodeling and quality of life, and the adverse effect rate was very low. Taken together, the favorable efficacy and safety of this drug guarantee ivabradine's inclusion in clinical practice guidelines for heart failure.