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Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS).
Authors:Marcus D Flather  Marcelo C Shibata  Andrew J S Coats  Dirk J Van Veldhuisen  Aleksandr Parkhomenko  Joszef Borbola  Alain Cohen-Solal  Dan Dumitrascu  Roberto Ferrari  Philippe Lechat  Jordi Soler-Soler  Luigi Tavazzi  Lenka Spinarova  Jiri Toman  Michael B?hm  Stefan D Anker  Simon G Thompson  Philip A Poole-Wilson
Institution:Clinical Trials and Evaluation Unit, Royal Brompton and Harefield NHS Trust, London, UK.
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%), 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.
Keywords:Heart failure  Elderly  Beta-blocker  Nebivolol  Randomized trial  Ejection fraction
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