B-blockade with nebivolol for prevention of acute ischaemic events in elderly patients with heart failure

Giuseppe Ambrosio, Marcus D. Flather, Michael Böhm, Alain Cohen-Solal, Adriano Murrone, Flavio Mascagni, Giulio Spinucci, Maria Giovanna Conti, Dirk J. van Veldhuisen, Luigi Tavazzi, Andrew J. S. Coats

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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 ß-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 ß-blockade in HF patients with underlying CAD.
Original languageEnglish
Pages (from-to)209-214
Number of pages6
Issue number3
Publication statusPublished - Feb 2011


  • Adrenergic beta-Antagonists
  • Aged
  • Aged, 80 and over
  • Benzopyrans
  • Epidemiologic Methods
  • Ethanolamines
  • Female
  • Heart Failure
  • Humans
  • Male
  • Myocardial Ischemia
  • Treatment Outcome
  • Vasodilator Agents

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