Skip to main content
Journal cover image

PredischaRge initiation of Ivabradine in the ManagEment of Heart Failure: Results of the PRIME-HF Trial.

Publication ,  Journal Article
Mentz, RJ; DeVore, AD; Tasissa, G; Heitner, JF; Piña, IL; Lala, A; Cole, RT; Lanfear, DD; Patel, CB; Ginwalla, M; Old, W; Salacata, AS ...
Published in: Am Heart J
May 2020

BACKGROUND: Ivabradine is guideline-recommended to reduce heart failure (HF) hospitalization in patients with stable chronic HF with reduced ejection fraction (EF). Ivabradine initiation following acute HF has had limited evaluation, and there are few randomized data in US patients. The PredischaRge initiation of Ivabradine in the ManagEment of Heart Failure (PRIME-HF) study was conducted to address predischarge ivabradine initiation in stabilized acute HF patients. METHODS: PRIME-HF was an investigator-initiated, randomized, open-label study of predischarge initiation of ivabradine versus usual care. Eligible patients were hospitalized for acute HF but stabilized, with EF ≤35%, on maximally tolerated β-blocker and in sinus rhythm with heart rate ≥70 beats/min. Ivabradine was acquired per routine care. The primary end point was the proportion of patients on ivabradine at 180 days. Additional end points included heart rate change, patient-reported outcomes, β-blocker use/dose, and safety events (symptomatic bradycardia and hypotension). RESULTS: Overall, 104 patients (36% women, 64% African American) were randomized, and the study was terminated early because of funding limitations. At 180 days, 21 of 52 (40.4%) of patients randomized to predischarge initiation were treated with ivabradine compared with 6 of 52 (11.5%) randomized to usual care (odds ratio 5.19, 95% CI 1.88-14.33, P = .002). The predischarge initiation group experienced greater reduction in heart rate through 180 days (mean -10.0 beats/min, 95% CI -15.7 to -4.3 vs 0.7 beats/min, 95% CI -5.4 to 6.7, P = .011). Patient-reported outcomes, β-blocker use/dose, and safety events were similar (all P > .05). CONCLUSIONS: Ivabradine initiation prior to discharge among stabilized HF patients increased ivabradine use at 180 days and lowered heart rates without reducing β-blockers or increasing adverse events. As the trial did not achieve the planned enrollment, additional studies are needed.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

May 2020

Volume

223

Start / End Page

98 / 105

Location

United States

Related Subject Headings

  • Patient Discharge
  • Middle Aged
  • Male
  • Ivabradine
  • Humans
  • Heart Failure
  • Female
  • Chronic Disease
  • Cardiovascular System & Hematology
  • Cardiovascular Agents
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mentz, R. J., DeVore, A. D., Tasissa, G., Heitner, J. F., Piña, I. L., Lala, A., … Hernandez, A. F. (2020). PredischaRge initiation of Ivabradine in the ManagEment of Heart Failure: Results of the PRIME-HF Trial. Am Heart J, 223, 98–105. https://doi.org/10.1016/j.ahj.2019.12.024
Mentz, Robert J., Adam D. DeVore, Gudaye Tasissa, John F. Heitner, Ileana L. Piña, Anuradha Lala, Robert T. Cole, et al. “PredischaRge initiation of Ivabradine in the ManagEment of Heart Failure: Results of the PRIME-HF Trial.Am Heart J 223 (May 2020): 98–105. https://doi.org/10.1016/j.ahj.2019.12.024.
Mentz RJ, DeVore AD, Tasissa G, Heitner JF, Piña IL, Lala A, et al. PredischaRge initiation of Ivabradine in the ManagEment of Heart Failure: Results of the PRIME-HF Trial. Am Heart J. 2020 May;223:98–105.
Mentz, Robert J., et al. “PredischaRge initiation of Ivabradine in the ManagEment of Heart Failure: Results of the PRIME-HF Trial.Am Heart J, vol. 223, May 2020, pp. 98–105. Pubmed, doi:10.1016/j.ahj.2019.12.024.
Mentz RJ, DeVore AD, Tasissa G, Heitner JF, Piña IL, Lala A, Cole RT, Lanfear DD, Patel CB, Ginwalla M, Old W, Salacata AS, Bigelow R, Fonarow GC, Hernandez AF. PredischaRge initiation of Ivabradine in the ManagEment of Heart Failure: Results of the PRIME-HF Trial. Am Heart J. 2020 May;223:98–105.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

May 2020

Volume

223

Start / End Page

98 / 105

Location

United States

Related Subject Headings

  • Patient Discharge
  • Middle Aged
  • Male
  • Ivabradine
  • Humans
  • Heart Failure
  • Female
  • Chronic Disease
  • Cardiovascular System & Hematology
  • Cardiovascular Agents