***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIMS LIVE : LIFE is a multi-centre , open-label , prospect i ve 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 Question naire ( MLWHFQ ) total score after 6months . METHODS AND RESULTS 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 . CONCLUSIONS These contemporary prospect i ve 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 AIMS In heart failure ( HF ) with reduced ejection fraction and sinus rhythm , heart rate reduction with ivabradine reduces the composite incidence of cardiovascular death and HF hospitalization . METHODS AND RESULTS It is unclear whether the duration of HF prior to therapy independently affects outcomes and whether it modifies the effect of heart rate reduction . In SHIFT , 6505 patients with chronic HF ( left ventricular ejection fraction of ≤35 % ) , in sinus rhythm , heart rate of ≥70 b.p.m . , treated with guideline -recommended therapies , were r and omized to placebo or ivabradine . Outcomes and the treatment effect  of ivabradine in patients with different duration s of HF were examined . Prior to r and omization , 1416 ivabradine and 1459 placebo patients had HF duration of ≥4 weeks and < 1.5 years ; 836  ivabradine  and 806 placebo  patients had HF duration of 1.5 years to < 4 years , and 989 ivabradine and 999 placebo patients had HF duration of ≥4 years . Patients with longer duration of HF were older ( 62.5 years vs. 59.0 years ; P < 0.0001 ) , had more severe disease ( New York Heart Association classes III/IV in 56 % vs. 44.9 % ; P < 0.0001 ) and greater incidences of co-morbidities [ myocardial infa rct ion : 62.9 % vs. 49.4 % ( P < 0.0001 ) ; renal dysfunction : 31.5 % vs. 21.5 % ( P < 0.0001 ) ; peripheral artery disease : 7.0 % vs. 4.8 % ( P < 0.0001 ) ] compared with patients with a more recent diagnosis . After adjustments , longer HF duration was independently associated with poorer outcome . Effects of ivabradine were independent of HF duration . CONCLUSIONS Duration of HF predicts outcome independently of risk indicators such as higher age , greater severity and more co-morbidities . Heart rate reduction with ivabradine improved outcomes independently of HF duration . Thus , HF treatments should be initiated early and it is important to characterize HF population s according to the chronicity of HF in future trials AIMS To evaluate clinical profiles and outcomes in patients with systolic heart failure ( HF ) with or without diabetes , and the efficacy and safety of ivabradine ( heart rate-lowering agent ) with respect to diabetic status . METHODS AND RESULTS This is a post hoc analysis on patients in SHIFT , a r and omized controlled trial in adults in sinus rhythm with systolic HF , left ventricular ejection fraction ≤35 % , and resting heart rate ≥70 b.p.m . Patients were r and omized to ivabradine ( titrated to 7.5 mg bid ) or placebo . Diabetic status was established by medical history at baseline . The primary composite endpoint ( PCE ) was cardiovascular death or hospitalisation for worsening HF . Of 6505 patients , 30 % had diabetes , 32 % of whom used insulin .  The PCE was more frequent in patients with diabetes [ adjusted hazard ratio ( HR ) 1.18 , 95 % confidence interval ( CI ) 1.07 - 1.31 ; p = 0.001 ] , as was hospitalization for worsening HF ( adjusted HR 1.28 , 95 % CI 1.13 - 1.44 ; P < 0.001 ) , and was increased in patients treated with insulin ( adjusted HR 1.43 , 95 % CI 1.23 - 1.66 ; P < 0.01 vs. non-diabetics ) . Ivabradine  significantly reduced the PCE in patients with and without diabetes ( adjusted HR 0.80 , 95 % CI 0.68 - 0.94 and HR 0.84 , 95 % CI , 0.75 - 0.95 , respectively ; interaction P was non-significant ) vs.  placebo . Adverse events were significantly more frequent in patients with diabetes ( 78 % ) than without ( 74 % ) ( P < 0.001 ) . Regardless of diabetic status , the incidence of serious adverse events was not significantly different between ivabradine and placebo . CONCLUSIONS Comorbid diabetes in chronic HF worsens the prognosis of systolic HF patients . Irrespective of diabetic status , ivabradine  is effective and safe in these patients Objective : To evaluate the efficacy and safety of ivabradine for the treatment of Chinese patients with chronic heart failure based on the Chinese subgroup data of the systolic heart failure treatment with the I(f ) inhibitor ivabradine trial ( SHIFT ) . Method : A total of 6 558 stable out patients who presented symptoms of heart failure , with a left ventricular ejection fraction ( LVEF ) ≤35 % , sinus rhythms with a heart rate ≥70 bpm participated in the r and omized , double-blind , placebo-controlled , international multicenter clinical study .The subset of Chinese patients with heart rate ≥75 bpm was enrolled in the post-hoc subgroup analyses . Patients were r and omly allocated by computer-generated assignment through a telephone interactive voice response system to ivabradine group ( starting dose 5 mg bid , which was then uptitrated to the maximum 7.5 mg bid ) or matched placebo group . The clinical baseline characteristics of participants were obtained and analyzed . The primary outcome endpoint was a composite endpoint of cardiovascular death or hospitalization result ing from worsening HF.The primary safety endpoint included total incidence of adverse events during the study , bradycardia , and adverse visual reaction ( phosphenes ) . Results : A total of 49 Chinese centers enrolled a total of 225 patients with chronic heart failure , of whom , 106 patients were r and omized to the ivabradine group and the other 119 patients to the  placebo group , and the mean follow-up time was ( 15.6±5.1 ) months . By the end of the study , mean heart rate ( 71.0 bpm vs. 80.3 bpm , P<0.05 ) and incidence of the primary endpoint events ( 18.9 % ( 20/106 ) vs. 31.9%(38/119 ) , HR=0.56 , 95%CI 0.33 - 0.97 , P=0.039 ) were significantly lower , while the percentage of patients with improvement in heart functional class NYHA ( 53.8 % ( 56/106 ) vs. 34.5 % ( 41/119 ) , P=0.006 1 ) was significantly higher in the ivabradine group than in the placebo group . The total number of adverse events ( 129 events , 49.6 % PY ) in the ivabradine group was lower than that in the placebo group ( 203 events , 50.8 % PY ) . In the ivabradine group and the placebo group , there were respectively 2 patients ( 1.9 % ) and 0 patients experienced bradycardia , 3 patients ( 2.9 % ) and 1 patient ( 0.8 % ) experienced adverse visual reaction ( phosphenes ) . Conclusions : Ivabradine significantly reduced heart rate and improved the clinical outcomes and NYHA function class in Chinese patients with chronic heart failure , these beneficial effects are achieved without inducing remarkable adverse reactions . The results of Chinese subgroup analysis were thus consistent with the overall results of the SHIFT study . Clinical Trial Registry : International st and ard r and omized controlled trials registry , IS RCT N 70429960 Introduction In the prospect i ve , open-label multicenter INTENSIFY study , the effectiveness and tolerability of ivabradine as well as its impact on quality of life ( QOL ) in chronic systolic heart failure ( CHF ) patients were evaluated over a 4-month period . Methods In CHF patients with an indication for treatment with ivabradine , resting heart rate ( HR ) , heart failure symptoms [ New York Heart Association ( NYHA ) class , signs of decompensation ] , left ventricular ejection fraction , brain natriuretic peptide ( BNP ) values , QOL , and concomitant medication with focus on beta-blocker therapy were documented at baseline , after 4 weeks , and after 4 months . The results were analyzed using descriptive statistical methods . Results Thous and nine hundred and fifty-six patients with CHF were included . Their mean age was 67 ± 11.7 years and 56.9 % were male . 77.8 % were receiving beta-blockers . Other concomitant medications included angiotensin-converting enzyme inhibitors or angiotensin receptor blockers ( 83 % ) , diuretics ( 61 % ) , aldosterone antagonists ( 18 % ) , and cardiac glycosides ( 8 % ) . At baseline , the mean HR of patients was 85 ± 11.8 bpm , 51.1 % and 37.2 % of patients were classified as NYHA II and III , respectively , and 22.7 % showed signs of decompensation . BNP concentrations were tracked in a subgroup , and values exceeding 400 pg/mL were noted in 53.9 % of patients . The mean value of the European quality of life-5 dimensions ( EQ-5D ) QOL index was 0.64 ± 0.28 . After 4 months of treatment with ivabradine , HR was reduced to 67 ± 8.9 bpm . Furthermore , the proportion of patients presenting with signs of decompensation decreased to 5.4 % and the proportion of patients with BNP levels > 400 pg/mL dropped to 26.7 % , accompanied by a shift in NYHA classification towards lower grading ( 24.0 % and 60.5 % in NYHA I and II , respectively ) . EQ-5D index improved to 0.79 ± 0.21 . Conclusion Over 4 months of treatment , ivabradine  effectively reduced HR and symptoms in CHF patients in this study reflecting daily clinical practice . These benefits were accompanied by improved QOL and good general tolerability BACKGROUND An elevated heart rate is an established marker of cardiovascular risk . Previous analyses have suggested that ivabradine , a heart-rate-reducing agent , may improve outcomes in patients with stable coronary artery disease , left ventricular dysfunction , and a heart rate of 70 beats per minute or more . METHODS We conducted a r and omized , double-blind , placebo-controlled trial of ivabradine , added to st and ard background therapy , in 19,102 patients who had both stable coronary artery disease without clinical heart failure and a heart rate of 70 beats per minute or more ( including 12,049 patients with activity-limiting angina [ class ≥II on the Canadian Cardiovascular Society scale , which ranges from I to IV , with higher classes indicating greater limitations on physical activity owing to angina ] ) . We r and omly assigned patients to placebo or ivabradine , at a dose of up to 10 mg twice daily , with the dose adjusted to achieve a target heart rate of 55 to 60 beats per minute 
    Output:
    
Conclusions : The results of this study will summary provide up-to- date d evidence for assessing the efficacy and safety of ivabradine for HF .