β-blockade with nebivolol for prevention of acute ischaemic events in elderly patients with heart failure
Identifieur interne : 006542 ( Main/Exploration ); précédent : 006541; suivant : 006543β-blockade with nebivolol for prevention of acute ischaemic events in elderly patients with heart failure
Auteurs : Giuseppe Ambrosio [Italie] ; Marcus D. Flather [Royaume-Uni] ; Michael Böhm [Allemagne] ; Alain Cohen-Solal [France] ; Adriano Murrone [Italie] ; Flavio Mascagni [Italie] ; Giulio Spinucci [Italie] ; Maria Giovanna Conti [Italie] ; Dirk J. Van Veldhuisen [Pays-Bas] ; Luigi Tavazzi [Italie] ; Andrew J. S. Coats [Australie]Source :
- Heart : (London 1996) [ 1355-6037 ] ; 2011.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Personne âgée.
English descriptors
- KwdEn :
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.
Affiliations:
- Allemagne, Australie, France, Italie, Pays-Bas, Royaume-Uni
- Angleterre, Grand Londres, Groningue (province), Nouvelle-Galles du Sud, Île-de-France
- Groningue, Londres, Paris, Sydney
- Université de Sydney
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Van Veldhuisen</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Department of Cardiology, University Medical Center Groningen, University of Groningen</s1><s2>Groningen</s2><s3>NLD</s3><sZ>9 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author><author><name sortKey="Tavazzi, Luigi" sort="Tavazzi, Luigi" uniqKey="Tavazzi L" first="Luigi" last="Tavazzi">Luigi Tavazzi</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Department of Cardiology, IRCCS Policlinico San Matteo</s1><s2>Pavia</s2><s3>ITA</s3><sZ>10 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Pavia</wicri:noRegion></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. 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Flather</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Clinical Trials and Investigation Unit, Royal Brompton and Harefield NHS Trust</s1><s2>London</s2><s3>GBR</s3><sZ>2 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Bohm, Michael" sort="Bohm, Michael" uniqKey="Bohm M" first="Michael" last="Böhm">Michael Böhm</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Klinik für Innere Medizin III, Universität des Saarlandes</s1><s2>Homburg/Saar</s2><s3>DEU</s3><sZ>3 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Homburg/Saar</wicri:noRegion><wicri:noRegion>Universität des Saarlandes</wicri:noRegion><wicri:noRegion>Homburg/Saar</wicri:noRegion></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="3"><inist:fA14 i1="04"><s1>INSERM U942; Faculté Paris 7 Paris Diderot; Hopital Lariboisiere</s1><s2>Paris</s2><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Murrone, Adriano" sort="Murrone, Adriano" uniqKey="Murrone A" first="Adriano" last="Murrone">Adriano Murrone</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Division of Cardiology, University of Perugia School of Medicine</s1><s2>Perugia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Perugia</wicri:noRegion></affiliation></author><author><name sortKey="Mascagni, Flavio" sort="Mascagni, Flavio" uniqKey="Mascagni F" first="Flavio" last="Mascagni">Flavio Mascagni</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Data Management & Biometry Unit, CAST and TRIAL, Pozzo della Chiana</s1><s3>ITA</s3><sZ>6 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Data Management & Biometry Unit, CAST and TRIAL, Pozzo della Chiana</wicri:noRegion></affiliation></author><author><name sortKey="Spinucci, Giulio" sort="Spinucci, Giulio" uniqKey="Spinucci G" first="Giulio" last="Spinucci">Giulio Spinucci</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Division of Cardiology, University of Perugia School of Medicine</s1><s2>Perugia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Perugia</wicri:noRegion></affiliation></author><author><name sortKey="Giovanna Conti, Maria" sort="Giovanna Conti, Maria" uniqKey="Giovanna Conti M" first="Maria" last="Giovanna Conti">Maria Giovanna Conti</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Division of Cardiology, University of Perugia School of Medicine</s1><s2>Perugia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Perugia</wicri:noRegion></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="3"><inist:fA14 i1="06"><s1>Department of Cardiology, University Medical Center Groningen, University of Groningen</s1><s2>Groningen</s2><s3>NLD</s3><sZ>9 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author><author><name sortKey="Tavazzi, Luigi" sort="Tavazzi, Luigi" uniqKey="Tavazzi L" first="Luigi" last="Tavazzi">Luigi Tavazzi</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Department of Cardiology, IRCCS Policlinico San Matteo</s1><s2>Pavia</s2><s3>ITA</s3><sZ>10 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Pavia</wicri:noRegion></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="4"><inist:fA14 i1="08"><s1>Faculty of Medicine, University of Sydney</s1><s3>AUS</s3><sZ>11 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author></analytic><series><title level="j" type="main">Heart : (London 1996)</title><title level="j" type="abbreviated">Heart : (Lond. 1996)</title><idno type="ISSN">1355-6037</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Heart : (London 1996)</title><title level="j" type="abbreviated">Heart : (Lond. 1996)</title><idno type="ISSN">1355-6037</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute</term><term>Cardiology</term><term>Circulatory system</term><term>Elderly</term><term>Heart failure</term><term>Ischemia</term><term>Nebivolol</term><term>Patient</term><term>Prevention</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Ischémie</term><term>Insuffisance cardiaque</term><term>Nébivolol</term><term>Prévention</term><term>Aigu</term><term>Personne âgée</term><term>Malade</term><term>Appareil circulatoire</term><term>Cardiologie</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Personne âgée</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Groningue (province)</li><li>Nouvelle-Galles du Sud</li><li>Île-de-France</li></region><settlement><li>Groningue</li><li>Londres</li><li>Paris</li><li>Sydney</li></settlement><orgName><li>Université de Sydney</li></orgName></list><tree><country name="Italie"><noRegion><name sortKey="Ambrosio, Giuseppe" sort="Ambrosio, Giuseppe" uniqKey="Ambrosio G" first="Giuseppe" last="Ambrosio">Giuseppe Ambrosio</name></noRegion><name sortKey="Giovanna Conti, Maria" sort="Giovanna Conti, Maria" uniqKey="Giovanna Conti M" first="Maria" last="Giovanna Conti">Maria Giovanna Conti</name><name sortKey="Mascagni, Flavio" sort="Mascagni, Flavio" uniqKey="Mascagni F" first="Flavio" last="Mascagni">Flavio Mascagni</name><name sortKey="Murrone, Adriano" sort="Murrone, Adriano" uniqKey="Murrone A" first="Adriano" last="Murrone">Adriano Murrone</name><name sortKey="Spinucci, Giulio" sort="Spinucci, Giulio" uniqKey="Spinucci G" first="Giulio" last="Spinucci">Giulio Spinucci</name><name sortKey="Tavazzi, Luigi" sort="Tavazzi, Luigi" uniqKey="Tavazzi L" first="Luigi" last="Tavazzi">Luigi Tavazzi</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Flather, Marcus D" sort="Flather, Marcus D" uniqKey="Flather M" first="Marcus D." last="Flather">Marcus D. Flather</name></region></country><country name="Allemagne"><noRegion><name sortKey="Bohm, Michael" sort="Bohm, Michael" uniqKey="Bohm M" first="Michael" last="Böhm">Michael Böhm</name></noRegion></country><country name="France"><region name="Île-de-France"><name sortKey="Cohen Solal, Alain" sort="Cohen Solal, Alain" uniqKey="Cohen Solal A" first="Alain" last="Cohen-Solal">Alain Cohen-Solal</name></region></country><country name="Pays-Bas"><region name="Groningue (province)"><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></region></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><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></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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