Β-blockade with nebivolol for prevention of acute ischaemic events in elderly patients with heart failure. Issue 3 (6th December 2010)

• Record Type: Journal Article
• Authors: Ambrosio, Giuseppe; Flather, Marcus D; Böhm, Michael; Cohen-Solal, Alain; Murrone, Adriano; Mascagni, Flavio; Spinucci, Giulio; Conti, Maria Giovanna; van Veldhuisen, Dirk J; Tavazzi, Luigi; Coats, Andrew J S
• Is Part Of: Heart. Volume 97:Issue 3(2011)
• Page Start: 209
• Page End: 214
• Publication Date: 2010-12-06
• Subjects: Acute coronary syndrome -- β-blocker -- coronary artery disease -- heart failure -- ischaemic events -- nebivolol -- nitric oxide; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2010.207365
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objectives: This subanalysis of the Study of the Effects of Nebivolol Intervention on Outcomes and Hospitalisation in Seniors with Heart Failure (SENIORS) investigates whether treatment with nebivolol, a β-blocker with nitric oxide-releasing properties, can provide additional benefits besides its effects on heart failure (HF), by reducing cardiac ischaemic events in patients with HF of ischaemic aetiology. Design: A double-blind, randomised, placebo-controlled, multicentre trial of nebivolol in 2128 elderly patients. Patients and interventions: For this analysis, data were extracted for 2128 elderly (≥70 years) HF patients in whom coronary artery disease (CAD) was the underlying aetiology (68.2%; 717 placebo-treated patients and 735 assigned to nebivolol). Main outcome measures: The main endpoint was the composite of cardiac ischaemic events at 2 year follow-up: death/hospitalisation for myocardial infarction, unstable angina or sudden death, as originally identified in the case report form. Results: At follow-up, nebivolol treatment was associated with a one-third reduction in the risk of ischaemic events, the composite endpoint occurring in 15.9% of placebo and 10.7% of nebivolol-treated patients (HR 0.68; 95% CI 0.51 to 0.90; p=0.008). This effect was independent of age, gender and ejection fraction. No difference in this composite endpoint was observed in the subgroup of patients of non-ischaemic aetiology. Conclusions: Nebivolol was effective in reducing cardiac ischaemic events in patients with HF of ischaemic aetiology. The prevention of ischaemic events can be an additional beneficial effect of β-blockade in HF patients with underlying CAD.