B-blockade with nebivolol for prevention of acute ischaemic events in elderly patients with heart failure

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 and Coats, Andrew J. S. (2011) B-blockade with nebivolol for prevention of acute ischaemic events in elderly patients with heart failure. Heart, 97 (3). pp. 209-214. ISSN 1355-6037

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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 ß-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 ß-blockade in HF patients with underlying CAD.

Item Type: Article
Uncontrolled Keywords: adrenergic beta-antagonists,aged,aged, 80 and over,benzopyrans,epidemiologic methods,ethanolamines,female,heart failure,humans,male,myocardial ischemia,treatment outcome,vasodilator agents
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Rhiannon Harvey
Date Deposited: 03 Jan 2012 17:07
Last Modified: 21 Apr 2020 16:39
URI: https://ueaeprints.uea.ac.uk/id/eprint/35880
DOI: 10.1136/hrt.2010.207365

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