alexa β-blockade with nebivolol for prevention of acute ischaemic events in elderly patients with heart failure.


Journal of Hypertension: Open Access

Author(s): Ambrosio G, Flather MD, Bhm M, CohenSolal A, Murrone A,

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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. This article was published in Heart and referenced in Journal of Hypertension: Open Access

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