title: Ivabradine, a novel medication for treatment of heart failure with reduced ejection fraction.
abstract: OBJECTIVE
  To critically evaluate current literature, review pharmacology, and discuss clinical role of ivabradine for patients with heart failure (HF) with reduced ejection fraction.
  
  
  METHODS
  A PubMed search was conducted using the search terms ivabradine and HF. All human studies analyzing the use of ivabradine in patients with HF with reduced ejection fraction and prescribing information were evaluated.
  
  
  CONCLUSIONS
  Greater benefit was seen in the prespecified subgroup with heart rate (HR) > 70 beats per minute (bpm) in the BEAUTIFUL study. Therefore, SHIFT examined the effect of ivabradine on patients with higher resting HR, lower ejection fraction, who had been hospitalized for HF within the previous year. A significant difference was found in the composite primary endpoint of cardiovascular death and hospitalizations for worsening HF in patients with HF and left ventricular systolic dysfunction, driven primarily by reduction in hospitalizations for worsening HF. The most common adverse effect was bradycardia.
  
  
  CONCLUSIONS
  Ivabradine is a safe and effective medication for HR reduction to reduce hospitalizations in patients with stable, symptomatic HF (ejection fraction < 35%), in sinus rhythm, and HR > 70 bpm.
authors.affiliation: Department of Pharmaceutical Services and Clinical Nutrition, Palmetto Health Richland, Columbia, South Carolina.|South Carolina College of Pharmacy, Columbia, South Carolina.
authors.forename: Jenna L
authors.initials: JL
authors.lastname: Foster
authors.affiliation: South Carolina College of Pharmacy, Columbia, South Carolina.|Midlands Cardiology Associates, Columbia, South Carolina.
authors.forename: Rodel V
authors.initials: RV
authors.lastname: Bobadilla
mesh_terms: D001552:Benzazepines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D000077550:Ivabradine; D013318:Stroke Volume / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D001552:Benzazepines; D000077550:Ivabradine
keywords: Heart failure; cardiovascular; hospital readmission; medications