Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS)
Identifieur interne : 000687 ( Istex/Curation ); précédent : 000686; suivant : 000688Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS)
Auteurs : Marcus D. Flather [Royaume-Uni] ; Marcelo C. Shibata [Royaume-Uni, Canada] ; Andrew J. S. Coats [Australie] ; Dirk J. Van Veldhuisen [Pays-Bas] ; Aleksandr Parkhomenko [Ukraine] ; Joszef Borbola [Hongrie] ; Alain Cohen-Solal [France] ; Dan Dumitrascu [Roumanie] ; Roberto Ferrari [Italie] ; Philippe Lechat [France] ; Jordi Soler-Soler [Espagne] ; Luigi Tavazzi [Italie] ; Lenka Spinarova [République tchèque] ; Jiri Toman [République tchèque] ; Michael Bo Hm [Allemagne] ; Stefan D. Anker [Allemagne] ; Simon G. Thompson [Royaume-Uni] ; Philip A. Poole-Wilson [Royaume-Uni]Source :
- European Heart Journal [ 0195-668X ] ; 2005-02.
English descriptors
- KwdEn :
- Adverse events, Aleksandr parkhomenko, Annual rate, Baseline, Beta adrenergic blockade, Beta blockers, Beta-blocker, Blocker, Blood pressure, Broad range, Cardiac, Cardiology, Cardiovascular, Cardiovascular deaths, Cardiovascular hospital admission, Cardiovascular hospital admissions, Cardiovascular mortality, Carvedilol, Cause death, Cause hospital admissions, Cause hospitalization, Cause mortality, Charite campus berlin, Chronic heart failure, Clinical trials, Cluj napoca, Coll cardiol, Congestive heart failure, Czech republic, Data management, Data safety, Diastolic blood pressure, Diastolic heart failure, Drug intake, Ejection, Ejection fraction, Elderly, Elderly heart failure patients, Elderly patients, European heart journal, European society, Evaluation unit, Flather, Hazard ratio, Heart failure, Heart rate, Hopital paris, Hospital admission, Hospital admissions, Hungarian institute, Imperial college, Interaction test, Irccs policlinico, Jiri toman, Lancet, Large randomized trials, Last observation, Lenka spinarova, Luigi tavazzi, Maintenance dose, Marcelo shibata, Marcus flather, Masaryk university hospital, Median, Medical research council biostatistics unit, Menarini ricerche, Michael bohm, Mmhg, Monitoring committee, Morbidity studies, Mudr, Myocardial infarction, Nebivolol, Nebivolol group, Nebivolol intervention, Placebo, Placebo group, Placebo groups, Previous studies, Previous trials, Previous year, Primary endpoint, Primary outcome, Primary outcomec, Prof, Randomization, Randomized, Randomized trial, Randomized trials, Risk reduction, Roberto ferrari, Royal brompton, Safety concerns, Safety monitoring committee, Salvatore maugeri foundation, Sample size, Science technology, Secondary outcomes, Seniors study, Seniors trial, Steering committee, Study medication, Subgroup, Systolic, Systolic blood pressure, Task force, Titration phase, Unadjusted analysis, Vall barcelona, Vasodilating properties, Ventricular, Ventricular dysfunction, Ventricular ejection fraction, Ventricular function, Younger patients.
- Teeft :
- Adverse events, Aleksandr parkhomenko, Annual rate, Baseline, Beta adrenergic blockade, Beta blockers, Blocker, Blood pressure, Broad range, Cardiac, Cardiology, Cardiovascular, Cardiovascular deaths, Cardiovascular hospital admission, Cardiovascular hospital admissions, Cardiovascular mortality, Carvedilol, Cause death, Cause hospital admissions, Cause hospitalization, Cause mortality, Charite campus berlin, Chronic heart failure, Clinical trials, Cluj napoca, Coll cardiol, Congestive heart failure, Czech republic, Data management, Data safety, Diastolic blood pressure, Diastolic heart failure, Drug intake, Ejection, Ejection fraction, Elderly heart failure patients, Elderly patients, European heart journal, European society, Evaluation unit, Flather, Hazard ratio, Heart failure, Heart rate, Hopital paris, Hospital admission, Hospital admissions, Hungarian institute, Imperial college, Interaction test, Irccs policlinico, Jiri toman, Lancet, Large randomized trials, Last observation, Lenka spinarova, Luigi tavazzi, Maintenance dose, Marcelo shibata, Marcus flather, Masaryk university hospital, Median, Medical research council biostatistics unit, Menarini ricerche, Michael bohm, Mmhg, Monitoring committee, Morbidity studies, Mudr, Myocardial infarction, Nebivolol, Nebivolol group, Nebivolol intervention, Placebo, Placebo group, Placebo groups, Previous studies, Previous trials, Previous year, Primary endpoint, Primary outcome, Primary outcomec, Prof, Randomization, Randomized, Randomized trials, Risk reduction, Roberto ferrari, Royal brompton, Safety concerns, Safety monitoring committee, Salvatore maugeri foundation, Sample size, Science technology, Secondary outcomes, Seniors study, Seniors trial, Steering committee, Study medication, Subgroup, Systolic, Systolic blood pressure, Task force, Titration phase, Unadjusted analysis, Vall barcelona, Vasodilating properties, Ventricular, Ventricular dysfunction, Ventricular ejection fraction, Ventricular function, Younger patients.
Abstract
Aims Large randomized trials have shown that beta-blockers reduce mortality and hospital admissions in patients with heart failure. The effects of beta-blockers in elderly patients with a broad range of left ventricular ejection fraction are uncertain. The SENIORS study was performed to assess effects of the beta-blocker, nebivolol, in patients ≥70 years, regardless of ejection fraction. Methods and results We randomly assigned 2128 patients aged ≥70 years with a history of heart failure (hospital admission for heart failure within the previous year or known ejection fraction ≤35%), 1067 to nebivolol (titrated from 1.25 mg once daily to 10 mg once daily), and 1061 to placebo. The primary outcome was a composite of all cause mortality or cardiovascular hospital admission (time to first event). Analysis was by intention to treat. Mean duration of follow-up was 21 months. Mean age was 76 years (SD 4.7), 37% were female, mean ejection fraction was 36% (with 35% having ejection fraction >35%), and 68% had a prior history of coronary heart disease. The mean maintenance dose of nebivolol was 7.7 mg and of placebo 8.5 mg. The primary outcome occurred in 332 patients (31.1%) on nebivolol compared with 375 (35.3%) on placebo [hazard ratio (HR) 0.86, 95% CI 0.74–0.99; P=0.039]. There was no significant influence of age, gender, or ejection fraction on the effect of nebivolol on the primary outcome. Death (all causes) occurred in 169 (15.8%) on nebivolol and 192 (18.1%) on placebo (HR 0.88, 95% CI 0.71–1.08; P=0.21). Conclusion Nebivolol, a beta-blocker with vasodilating properties, is an effective and well-tolerated treatment for heart failure in the elderly.
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DOI: 10.1093/eurheartj/ehi115
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Andrew J. S. Coats<affiliation><mods:affiliation></mods:affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation><affiliation><mods:affiliation>E-mail: </mods:affiliation></affiliation><affiliation><mods:affiliation>Corresponding author. Tel: +61293514579; fax +61293516645. E-mail address: ajscoats@aol.com</mods:affiliation></affiliation>Le document en format XML
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Cardiology, IRCCS Policlinico San Matteo, Pavia</wicri:regionArea></affiliation></author><author><name sortKey="Spinarova, Lenka" sort="Spinarova, Lenka" uniqKey="Spinarova L" first="Lenka" last="Spinarova">Lenka Spinarova</name><affiliation wicri:level="1"><mods:affiliation>1st Department of Medicine, Masaryk University Hospital, Brno, Czech Republic</mods:affiliation><country xml:lang="fr">République tchèque</country><wicri:regionArea>1st Department of Medicine, Masaryk University Hospital, Brno</wicri:regionArea></affiliation></author><author><name sortKey="Toman, Jiri" sort="Toman, Jiri" uniqKey="Toman J" first="Jiri" last="Toman">Jiri Toman</name><affiliation wicri:level="1"><mods:affiliation>1st Department of Medicine, Masaryk University Hospital, Brno, Czech Republic</mods:affiliation><country xml:lang="fr">République tchèque</country><wicri:regionArea>1st Department of Medicine, Masaryk University Hospital, Brno</wicri:regionArea></affiliation></author><author><name sortKey="Bo 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Poole-Wilson</name><affiliation wicri:level="1"><mods:affiliation>National Heart and Lung Institute, Imperial College of Science Technology and Medicine, London, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>National Heart and Lung Institute, Imperial College of Science Technology and Medicine, London</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:233088D5382ECAD4BF8A5104C5D468729CDD526F</idno><date when="2005" year="2005">2005</date><idno type="doi">10.1093/eurheartj/ehi115</idno><idno type="url">https://api.istex.fr/document/233088D5382ECAD4BF8A5104C5D468729CDD526F/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000687</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000687</idno><idno type="wicri:Area/Istex/Curation">000687</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS)</title><author><name sortKey="Flather, Marcus D" sort="Flather, Marcus D" uniqKey="Flather M" first="Marcus D." last="Flather">Marcus D. Flather</name><affiliation wicri:level="1"><mods:affiliation>Clinical Trials and Evaluation Unit, Royal Brompton and Harefield NHS Trust, London, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Clinical Trials and Evaluation Unit, Royal Brompton and Harefield NHS Trust, London</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>National Heart and Lung Institute, Imperial College of Science Technology and Medicine, London, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>National Heart and Lung Institute, Imperial College of Science Technology and Medicine, London</wicri:regionArea></affiliation></author><author><name sortKey="Shibata, Marcelo C" sort="Shibata, Marcelo C" uniqKey="Shibata M" first="Marcelo C." last="Shibata">Marcelo C. Shibata</name><affiliation wicri:level="1"><mods:affiliation>Clinical Trials and Evaluation Unit, Royal Brompton and Harefield NHS Trust, London, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Clinical Trials and Evaluation Unit, Royal Brompton and Harefield NHS Trust, London</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Division of Cardiology, University of Alberta, Edmonton, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Cardiology, University of Alberta, Edmonton</wicri:regionArea></affiliation></author><author><name sortKey="Coats, Andrew J S" sort="Coats, Andrew J S" uniqKey="Coats A" first="Andrew J. S." last="Coats">Andrew J. S. Coats</name><affiliation wicri:level="1"><mods:affiliation>Faculty of Medicine, University of Sydney, Sydney 2006, Australia</mods:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Faculty of Medicine, University of Sydney, Sydney 2006</wicri:regionArea></affiliation><affiliation><mods:affiliation></mods:affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation><affiliation><mods:affiliation>E-mail: </mods:affiliation></affiliation><affiliation><mods:affiliation>Corresponding author. Tel: +61293514579; fax +61293516645. E-mail address: ajscoats@aol.com</mods:affiliation></affiliation></author><author><name sortKey="Van Veldhuisen, Dirk J" sort="Van Veldhuisen, Dirk J" uniqKey="Van Veldhuisen D" first="Dirk J." last="Van Veldhuisen">Dirk J. Van Veldhuisen</name><affiliation wicri:level="1"><mods:affiliation>Department of Cardiology, University Hospital, Groningen, The Netherlands</mods:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Cardiology, University Hospital, Groningen</wicri:regionArea></affiliation></author><author><name sortKey="Parkhomenko, Aleksandr" sort="Parkhomenko, Aleksandr" uniqKey="Parkhomenko A" first="Aleksandr" last="Parkhomenko">Aleksandr Parkhomenko</name><affiliation wicri:level="1"><mods:affiliation>Institute of Cardiology, Academy of Science of Ukraine, Kiev, Ukraine</mods:affiliation><country xml:lang="fr">Ukraine</country><wicri:regionArea>Institute of Cardiology, Academy of Science of Ukraine, Kiev</wicri:regionArea></affiliation></author><author><name sortKey="Borbola, Joszef" sort="Borbola, Joszef" uniqKey="Borbola J" first="Joszef" last="Borbola">Joszef Borbola</name><affiliation wicri:level="1"><mods:affiliation>Hungarian Institute of Cardiology, Budapest, Hungary</mods:affiliation><country xml:lang="fr">Hongrie</country><wicri:regionArea>Hungarian Institute of Cardiology, Budapest</wicri:regionArea></affiliation></author><author><name sortKey="Cohen Solal, Alain" sort="Cohen Solal, Alain" uniqKey="Cohen Solal A" first="Alain" last="Cohen-Solal">Alain Cohen-Solal</name><affiliation wicri:level="1"><mods:affiliation>Service de Cardiologie, Hôpital Beaujon, Clichy, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Cardiologie, Hôpital Beaujon, Clichy</wicri:regionArea></affiliation></author><author><name sortKey="Dumitrascu, Dan" sort="Dumitrascu, Dan" uniqKey="Dumitrascu D" first="Dan" last="Dumitrascu">Dan Dumitrascu</name><affiliation wicri:level="1"><mods:affiliation>University of Pharmacy and Medicine, Cluj Napoca, Romania</mods:affiliation><country xml:lang="fr">Roumanie</country><wicri:regionArea>University of Pharmacy and Medicine, Cluj Napoca</wicri:regionArea></affiliation></author><author><name sortKey="Ferrari, Roberto" sort="Ferrari, Roberto" uniqKey="Ferrari R" first="Roberto" last="Ferrari">Roberto Ferrari</name><affiliation wicri:level="1"><mods:affiliation>Department of Cardiology, University of Ferrara, Ferrara, Italy</mods:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Cardiology, University of Ferrara, Ferrara</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Cardiovascular Research Centre, Salvatore Maugeri Foundation, IRCCS, Gussago, Italy</mods:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Cardiovascular Research Centre, Salvatore Maugeri Foundation, IRCCS, Gussago</wicri:regionArea></affiliation></author><author><name sortKey="Lechat, Philippe" sort="Lechat, Philippe" uniqKey="Lechat P" first="Philippe" last="Lechat">Philippe Lechat</name><affiliation wicri:level="1"><mods:affiliation>Service de Pharmacologie, Hôpital Pitie-Salpetrière, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Pharmacologie, Hôpital Pitie-Salpetrière, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Soler Soler, Jordi" sort="Soler Soler, Jordi" uniqKey="Soler Soler J" first="Jordi" last="Soler-Soler">Jordi Soler-Soler</name><affiliation wicri:level="1"><mods:affiliation>Cardiology Division, Hospital General Vall d'Hebron, Barcelona, Spain</mods:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Cardiology Division, Hospital General Vall d'Hebron, Barcelona</wicri:regionArea></affiliation></author><author><name sortKey="Tavazzi, Luigi" sort="Tavazzi, Luigi" uniqKey="Tavazzi L" first="Luigi" last="Tavazzi">Luigi Tavazzi</name><affiliation wicri:level="1"><mods:affiliation>Department of Cardiology, IRCCS Policlinico San Matteo, Pavia, Italy</mods:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Cardiology, IRCCS Policlinico San Matteo, Pavia</wicri:regionArea></affiliation></author><author><name sortKey="Spinarova, Lenka" sort="Spinarova, Lenka" uniqKey="Spinarova L" first="Lenka" last="Spinarova">Lenka Spinarova</name><affiliation wicri:level="1"><mods:affiliation>1st Department of Medicine, Masaryk University Hospital, Brno, Czech Republic</mods:affiliation><country xml:lang="fr">République tchèque</country><wicri:regionArea>1st Department of Medicine, Masaryk University Hospital, Brno</wicri:regionArea></affiliation></author><author><name sortKey="Toman, Jiri" sort="Toman, Jiri" uniqKey="Toman J" first="Jiri" last="Toman">Jiri Toman</name><affiliation wicri:level="1"><mods:affiliation>1st Department of Medicine, Masaryk University Hospital, Brno, Czech Republic</mods:affiliation><country xml:lang="fr">République tchèque</country><wicri:regionArea>1st Department of Medicine, Masaryk University Hospital, Brno</wicri:regionArea></affiliation></author><author><name sortKey="Bo Hm, Michael" sort="Bo Hm, Michael" uniqKey="Bo Hm M" first="Michael" last="Bo Hm">Michael Bo Hm</name><affiliation wicri:level="1"><mods:affiliation>Universitätskliniken des Saarlandes, Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Homburg/Saar, Germany</mods:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Universitätskliniken des Saarlandes, Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Homburg/Saar</wicri:regionArea></affiliation></author><author><name sortKey="Anker, Stefan D" sort="Anker, Stefan D" uniqKey="Anker S" first="Stefan D." last="Anker">Stefan D. Anker</name><affiliation wicri:level="1"><mods:affiliation>Department of Cardiology, Charité Campus Virchow-Klinikum, Berlin, Germany</mods:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Cardiology, Charité Campus Virchow-Klinikum, Berlin</wicri:regionArea></affiliation></author><author><name sortKey="Thompson, Simon G" sort="Thompson, Simon G" uniqKey="Thompson S" first="Simon G." last="Thompson">Simon G. Thompson</name><affiliation wicri:level="1"><mods:affiliation>Medical Research Council Biostatistics Unit, Cambridge, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Biostatistics Unit, Cambridge</wicri:regionArea></affiliation></author><author><name sortKey="Poole Wilson, Philip A" sort="Poole Wilson, Philip A" uniqKey="Poole Wilson P" first="Philip A." last="Poole-Wilson">Philip A. Poole-Wilson</name><affiliation wicri:level="1"><mods:affiliation>National Heart and Lung Institute, Imperial College of Science Technology and Medicine, London, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>National Heart and Lung Institute, Imperial College of Science Technology and Medicine, London</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j">European Heart Journal</title><title level="j" type="abbrev">Eur Heart J</title><idno type="ISSN">0195-668X</idno><idno type="eISSN">1522-9645</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2005-02">2005-02</date><biblScope unit="volume">26</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="215">215</biblScope><biblScope unit="page" to="225">225</biblScope></imprint><idno type="ISSN">0195-668X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0195-668X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adverse events</term><term>Aleksandr parkhomenko</term><term>Annual rate</term><term>Baseline</term><term>Beta adrenergic blockade</term><term>Beta blockers</term><term>Beta-blocker</term><term>Blocker</term><term>Blood pressure</term><term>Broad range</term><term>Cardiac</term><term>Cardiology</term><term>Cardiovascular</term><term>Cardiovascular deaths</term><term>Cardiovascular hospital admission</term><term>Cardiovascular hospital admissions</term><term>Cardiovascular mortality</term><term>Carvedilol</term><term>Cause death</term><term>Cause hospital admissions</term><term>Cause hospitalization</term><term>Cause mortality</term><term>Charite campus berlin</term><term>Chronic heart failure</term><term>Clinical trials</term><term>Cluj napoca</term><term>Coll cardiol</term><term>Congestive heart failure</term><term>Czech republic</term><term>Data management</term><term>Data safety</term><term>Diastolic blood pressure</term><term>Diastolic heart failure</term><term>Drug intake</term><term>Ejection</term><term>Ejection fraction</term><term>Elderly</term><term>Elderly heart failure patients</term><term>Elderly patients</term><term>European heart journal</term><term>European society</term><term>Evaluation unit</term><term>Flather</term><term>Hazard ratio</term><term>Heart failure</term><term>Heart rate</term><term>Hopital paris</term><term>Hospital admission</term><term>Hospital admissions</term><term>Hungarian institute</term><term>Imperial college</term><term>Interaction test</term><term>Irccs policlinico</term><term>Jiri toman</term><term>Lancet</term><term>Large randomized trials</term><term>Last observation</term><term>Lenka spinarova</term><term>Luigi tavazzi</term><term>Maintenance dose</term><term>Marcelo shibata</term><term>Marcus flather</term><term>Masaryk university hospital</term><term>Median</term><term>Medical research council biostatistics unit</term><term>Menarini ricerche</term><term>Michael bohm</term><term>Mmhg</term><term>Monitoring committee</term><term>Morbidity studies</term><term>Mudr</term><term>Myocardial infarction</term><term>Nebivolol</term><term>Nebivolol group</term><term>Nebivolol intervention</term><term>Placebo</term><term>Placebo group</term><term>Placebo groups</term><term>Previous studies</term><term>Previous trials</term><term>Previous year</term><term>Primary endpoint</term><term>Primary outcome</term><term>Primary outcomec</term><term>Prof</term><term>Randomization</term><term>Randomized</term><term>Randomized trial</term><term>Randomized trials</term><term>Risk reduction</term><term>Roberto ferrari</term><term>Royal brompton</term><term>Safety concerns</term><term>Safety monitoring committee</term><term>Salvatore maugeri foundation</term><term>Sample size</term><term>Science technology</term><term>Secondary outcomes</term><term>Seniors study</term><term>Seniors trial</term><term>Steering committee</term><term>Study medication</term><term>Subgroup</term><term>Systolic</term><term>Systolic blood pressure</term><term>Task force</term><term>Titration phase</term><term>Unadjusted analysis</term><term>Vall barcelona</term><term>Vasodilating properties</term><term>Ventricular</term><term>Ventricular dysfunction</term><term>Ventricular ejection fraction</term><term>Ventricular function</term><term>Younger patients</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Adverse events</term><term>Aleksandr parkhomenko</term><term>Annual rate</term><term>Baseline</term><term>Beta adrenergic blockade</term><term>Beta blockers</term><term>Blocker</term><term>Blood pressure</term><term>Broad range</term><term>Cardiac</term><term>Cardiology</term><term>Cardiovascular</term><term>Cardiovascular deaths</term><term>Cardiovascular hospital admission</term><term>Cardiovascular hospital admissions</term><term>Cardiovascular mortality</term><term>Carvedilol</term><term>Cause death</term><term>Cause hospital admissions</term><term>Cause hospitalization</term><term>Cause mortality</term><term>Charite campus berlin</term><term>Chronic heart failure</term><term>Clinical trials</term><term>Cluj napoca</term><term>Coll cardiol</term><term>Congestive heart failure</term><term>Czech republic</term><term>Data management</term><term>Data safety</term><term>Diastolic blood pressure</term><term>Diastolic heart failure</term><term>Drug intake</term><term>Ejection</term><term>Ejection fraction</term><term>Elderly heart failure patients</term><term>Elderly patients</term><term>European heart journal</term><term>European society</term><term>Evaluation unit</term><term>Flather</term><term>Hazard ratio</term><term>Heart failure</term><term>Heart rate</term><term>Hopital paris</term><term>Hospital admission</term><term>Hospital admissions</term><term>Hungarian institute</term><term>Imperial college</term><term>Interaction test</term><term>Irccs policlinico</term><term>Jiri toman</term><term>Lancet</term><term>Large randomized trials</term><term>Last observation</term><term>Lenka spinarova</term><term>Luigi tavazzi</term><term>Maintenance dose</term><term>Marcelo shibata</term><term>Marcus flather</term><term>Masaryk university hospital</term><term>Median</term><term>Medical research council biostatistics unit</term><term>Menarini ricerche</term><term>Michael bohm</term><term>Mmhg</term><term>Monitoring committee</term><term>Morbidity studies</term><term>Mudr</term><term>Myocardial infarction</term><term>Nebivolol</term><term>Nebivolol group</term><term>Nebivolol intervention</term><term>Placebo</term><term>Placebo group</term><term>Placebo groups</term><term>Previous studies</term><term>Previous trials</term><term>Previous year</term><term>Primary endpoint</term><term>Primary outcome</term><term>Primary outcomec</term><term>Prof</term><term>Randomization</term><term>Randomized</term><term>Randomized trials</term><term>Risk reduction</term><term>Roberto ferrari</term><term>Royal brompton</term><term>Safety concerns</term><term>Safety monitoring committee</term><term>Salvatore maugeri foundation</term><term>Sample size</term><term>Science technology</term><term>Secondary outcomes</term><term>Seniors study</term><term>Seniors trial</term><term>Steering committee</term><term>Study medication</term><term>Subgroup</term><term>Systolic</term><term>Systolic blood pressure</term><term>Task force</term><term>Titration phase</term><term>Unadjusted analysis</term><term>Vall barcelona</term><term>Vasodilating properties</term><term>Ventricular</term><term>Ventricular dysfunction</term><term>Ventricular ejection fraction</term><term>Ventricular function</term><term>Younger patients</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Aims Large randomized trials have shown that beta-blockers reduce mortality and hospital admissions in patients with heart failure. The effects of beta-blockers in elderly patients with a broad range of left ventricular ejection fraction are uncertain. The SENIORS study was performed to assess effects of the beta-blocker, nebivolol, in patients ≥70 years, regardless of ejection fraction. Methods and results We randomly assigned 2128 patients aged ≥70 years with a history of heart failure (hospital admission for heart failure within the previous year or known ejection fraction ≤35%), 1067 to nebivolol (titrated from 1.25 mg once daily to 10 mg once daily), and 1061 to placebo. The primary outcome was a composite of all cause mortality or cardiovascular hospital admission (time to first event). Analysis was by intention to treat. Mean duration of follow-up was 21 months. Mean age was 76 years (SD 4.7), 37% were female, mean ejection fraction was 36% (with 35% having ejection fraction >35%), and 68% had a prior history of coronary heart disease. The mean maintenance dose of nebivolol was 7.7 mg and of placebo 8.5 mg. The primary outcome occurred in 332 patients (31.1%) on nebivolol compared with 375 (35.3%) on placebo [hazard ratio (HR) 0.86, 95% CI 0.74–0.99; P=0.039]. There was no significant influence of age, gender, or ejection fraction on the effect of nebivolol on the primary outcome. Death (all causes) occurred in 169 (15.8%) on nebivolol and 192 (18.1%) on placebo (HR 0.88, 95% CI 0.71–1.08; P=0.21). Conclusion Nebivolol, a beta-blocker with vasodilating properties, is an effective and well-tolerated treatment for heart failure in the elderly.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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