TY - JOUR
T1 - FASTTRACK Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS)
AU - Flather, Marcus D.
AU - Shibata, Marcelo C.
AU - Coats, Andrew J S
AU - Van Veldhuisen, Dirk J.
AU - Parkhomenko, Aleksandr
AU - Borbola, Joszef
AU - Cohen-Solal, Alain
AU - Dumitrascu, Dan
AU - Ferrari, Roberto
AU - Lechat, Philippe
AU - Soler-Soler, Jordi
AU - Tavazzi, Luigi
AU - Spinarova, Lenka
AU - Toman, Jiri
AU - Böhm, Michael
AU - Anker, Stefan D.
AU - Thompson, Simon G.
AU - Poole-Wilson, Philip A.
PY - 2005/2
Y1 - 2005/2
N2 - 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% Cl 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% Cl 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.
AB - 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% Cl 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% Cl 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.
KW - Beta-blocker
KW - Ejection fraction
KW - Elderly
KW - Heart failure
KW - Nebivolol
KW - Randomized trial
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U2 - 10.1093/eurheartj/ehi115
DO - 10.1093/eurheartj/ehi115
M3 - Article
C2 - 15642700
AN - SCOPUS:13544258730
VL - 26
SP - 215
EP - 225
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 3
ER -