Portsmouth Hospitals NHS Trust, Portsmouth, UK.
Medical Affairs Department, Servier Laboratories, UK.
Int J Cardiol. 2017 Dec 15;249:313-318. doi: 10.1016/j.ijcard.2017.08.001.
LIVE:LIFE is a multi-centre, open-label, prospective observational cohort study assessing health-related quality of life (HRQoL) in older patients with chronic heart failure (CHF) following initiation of ivabradine. The primary endpoint is change in Minnesota Living with Heart Failure Questionnaire (MLWHFQ) total score after 6months.
Consenting patients aged ≥70years with CHF, in whom ivabradine was initiated within its licensed indication, were enrolled. Demographic, clinical and HRQoL (MLWHFQ, SF-12) data were collected at baseline (V1), 2 (V2) and 6months (V3). Over 14months, 240 patients were recruited from 44 UK centres. Ninety-nine (41%) were female and 28% aged ≥80years. Aetiology was ischaemic in 152 (63%) and 59% had been diagnosed with CHF for ≤2yrs. 52% of patients were New York Heart Association (NYHA) Class III and 57% had left ventricular ejection fraction <35%. 57% received beta-blockers. Patients had multiple comorbidities (144 (60%) hypertension, 105 (44%) asthma/COPD, 80 (33%) diabetes) and were prescribed a mean of 9±3 daily medications. Resting heart rate was 83bpm at baseline and fell 13bpm by V3. In patients completing both visits (n=187), comparing V3 to baseline: MLWHFQ total score improved by 9 points (p<0.0001, 95% CI: 7-12); 30% of patients improved ≥1 NYHA class and global assessment improved from patient (59%) and physician (60%) perspectives. 88% of patients completing V3 were still taking ivabradine.
These contemporary prospective UK data demonstrate improvements in HRQoL and functional status with ivabradine therapy in typical older CHF patients. Despite comorbidities and polypharmacy, ivabradine was well tolerated.
LIVE:LIFE 是一项多中心、开放性、前瞻性观察队列研究，旨在评估慢性心力衰竭（CHF）老年患者在开始使用伊伐布雷定后的健康相关生活质量（HRQoL）。主要终点是 6 个月后明尼苏达州心力衰竭生活质量问卷（MLWHFQ）总分的变化。
入组患者年龄≥70 岁，患有 CHF，伊伐布雷定在其许可适应证内使用。收集人口统计学、临床和 HRQoL（MLWHFQ、SF-12）数据，分别在基线（V1）、2 个月（V2）和 6 个月（V3）时进行。在 14 个月内，从英国 44 个中心共招募了 240 名患者。99 名（41%）为女性，28%的年龄≥80 岁。病因在 152 名（63%）患者中为缺血性，59%的患者 CHF 诊断时间≤2 年。52%的患者为纽约心脏协会（NYHA）心功能分级 III 级，57%的患者左心室射血分数<35%。57%的患者接受β受体阻滞剂治疗。患者存在多种合并症（144 名[60%]患有高血压，105 名[44%]患有哮喘/COPD，80 名[33%]患有糖尿病），平均每天服用 9±3 种药物。静息心率在基线时为 83bpm，V3 时下降了 13bpm。在完成两次就诊的患者（n=187）中，与基线相比，V3 时 MLWHFQ 总分改善了 9 分（p<0.0001，95%CI：7-12）；30%的患者 NYHA 心功能分级改善≥1 级，患者（59%）和医生（60%）的整体评估得到改善。88%完成 V3 评估的患者仍在使用伊伐布雷定。
这些来自英国的当代前瞻性数据表明，在典型的老年 CHF 患者中，伊伐布雷定治疗可改善 HRQoL 和功能状态。尽管存在合并症和多种药物治疗，伊伐布雷定仍具有良好的耐受性。
