Ivabradine for Adults with Stable Chronic Heart Failure: A Review of Clinical Effectiveness
Bibliographic record
Abstract
Heart failure has been defined as “a complex clinical syndrome in which abnormal heart function results in, or increases the subsequent risk of, clinical symptoms and signs of reduced cardiac output and/or pulmonary or systemic congestion at rest or with stress. […] Chronic heart failure (CHF) is the preferred term representing the persistent and progressive nature of the disease.” Stable CHF is difficult to define, given that patients frequently deteriorate and are at risk of acute events.There are over 660,000 people living with heart failure in Canada and over 90,000 new cases diagnosed every year in Canada according to 2012/13 data. Both decreasing left ventricular ejection fraction (LVEF) and functional capacity (as characterized by the New York Heart Association (NYHA) Functional Classification) have been associated with higher mortality.,Ivabradine was approved by Health Canada in 2017 for the treatment of chronic heart failure (CHF) for patients with an ejection fraction of less than or equal to 35%, heart rate of 77 or greater, and NYHA classification II or III. Guidelines have endorsed ivabradine for treatment of patients with CHF and LVEF of less than or equal to 35%., One large trial used and supported the 35% threshold.Recently published guidelines suggested use of ivabradine in patients with ejection fractions of less than or equal to 40%., To inform decision making about use of ivabradine in an expanded population, a review was conducted to assess the current literature.The CADTH Common Drug Review Report for Lancora (ivabradine) assessed the evidence for the use of ivabradine in patients with LVEF of 35% and ≤40%. This report expands on the Summary of Abstracts by reviewing and assessing full text articles.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".