Real-World Effectiveness of Ivabradine in Chinese Patients with Chronic Heart Failure: Interim Analysis of the POSITIVE Study.

BACKGROUND: Ivabradine improves cardiac function and clinical outcomes in chronic heart failure (HF) by reducing heart rate (HR), but there is a lack of real-world data on its effectiveness and safety in Chinese patients. METHODS: We designed a prospective, multicenter, observational study of Chinese adults with HF and left ventricular systolic dysfunction, resting HR ≥ 75 beats per minute (bpm), and an indication for ivabradine treatment. An interim analysis was performed using a cut-off date of 31 October 2019. The primary outcome was change in HR at 6 months after the initiation of ivabradine. Secondary endpoints included change in New York Heart Association (NYHA) functional class; quality of life (QoL), measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ); and adverse events (AEs). RESULTS: Overall, 655 subjects were included in the interim analysis. Mean reduction in HR from baseline was 13.2 (95% confidence interval [CI] 11.2-15.2) bpm at Month 1, and 14.5 (95% CI 11.8-17.2) bpm at Month 6 (p < 0.001 for both changes). NYHA functional class and KCCQ scores improved significantly over time (p < 0.001 for all comparisons with baseline), indicating amelioration of symptoms and better QoL, respectively. Forty-four subjects (6.7%) reported a total of 60 ivabradine-related AEs, most frequently phosphenes and bradycardia (both n = 6, 0.9%). CONCLUSION: Treatment with ivabradine for 6 months effectively reduced HR and improved functional class and QoL in Chinese patients with chronic HF. Treatment was well tolerated. CLINICAL TRIAL REGISTRATION: ISRCTN11703380; registered on 8 November 2016.

[Anti-halitosis effect of sugar-free chewing gum].

OBJECTIVE: To study the anti-halitosis effect of sugar-free chewing gum through their influence on odor induced by cysteine. METHODS: Ten volunteers were randomly divided into the treatment group and the untreated group; each group consisted of five volunteers. All volunteers consented to participate in a test in which breath odor was induced by cysteine. After the test, the treatment group chewed sugar-free chewing gum for 1 min, whereas the untreated group did not undergo any treatment. The effectiveness was determined by the percent reduction of H2S, CH3SH, and (CH3)2S response after the volunteers chewed gum for 1, 10, and 20 min. RESULTS: At 1, 10, and 20 min, H2S of the treatment group was reduced by 82.68%, 92.27%, 97.47%, respectively, CH3SH was reduced by 65.49%, 73.79%, and 82.89%, respectively, and (CH3)2S was reduced by 60.45%, 73.82%, and 59.72%, respectively. The differences between the two groups at different times were significant (P < 0.05). CONCLUSION: Chewing gum can effectively inhibit cysteine-induced odor.