Suy tim mạn: GÓC NHÌN TỪ ACC 2017, PGS TS Châu Ngọc Hoa Bộ môn Nội ĐHYD Tp HCM

Suy tim mạn: GĨC NHÌN TỪ ACC 2017 PGS TS Châu Ngọc Hoa Bộ môn Nội ĐHYD Tp HCM ACC Focused update on HF, 2017 Two New Pharmacological Therapies Approved by FDA for Heart Failure • Ivabradine (April 15, 2015) • Sacubitril/Valsartan (July 7, 2015) WHO, WHEN AND WHY ADD ON IVABRADINE Ivabradine approval timeline • 2005 approved in EU for angina • 2012 approved in EU for heart failure • 2015 approved in US for heart failure to reduce the risk for hospitalization for worsening heart failure in patients with stable, symptomatic chronic heart failure with LVEF ≤35%, who are in sinus rhythm with a resting heart rate of ≥70 beats per minute (bpm) and are taking maximally tolerated doses of beta-blockers or have a contraindication to beta-blockers Ivabradine Blocks If channel Slows heart rate Few if any other CV effects SHIFT Trial > 6500 HF patients (NYHA II-IV) LVEF < 35% Resting HR > 70 BPM Primary endpoint: composite of CV death/HF hospitalization On maximally tolerated beta-blocker SHIFT: primary outcome CV death or hospitalization 40 for HF (%) HR= 0.82 p 70 BPM Primary endpoint: composite of CV death/HF hospitalization... hospitalized for WHF Better HR control 100 90 Ivabradine + BB 87 .3 BB alone 88 .4 HR, bpm 80 73.9 70.1 67 .8 70 60.6 60 50 Admission Dicharge months FU Hidalgo FJ et al Int J Cardiol 2016; 217: 7-11 Background