Coronary artery disease The BEAUTIFUL study randomised over 10917 patients having stable coronary artery disease and left ventricle dysfunction (ejection fraction < 40%).<unk>  did not show a significant reduction in the primary composite endpoint of cardiovascular death, admission to hospital for acute myocardial infarction, and admission to hospital for new onset or worsening heart failure. However, in a prespecified subgroup of patients with a heart rate of more than 70 bpm,<unk>  significantly reduced the following secondary endpoints: * Coronary events by 22% (P=0.023) * Fatal and nonfatal myocardial infarction by 36% (P=0.001) * Coronary revascularization by 30% (P=0.016). The SIGNIFY trial randomized 19,102 patients with coronary artery disease and a heart rate greater than 70, but without clinical heart failure to<unk>  or placebo in addition to standard therapy.<unk>  did not improve outcomes in this patient group. Chronic heart failure In the SHIFT study,<unk>  significantly reduced the risk of the primary composite endpoint of hospitalization for worsening heart failure or cardiovascular death by 18% (P<0.0001) compared with placebo on top of optimal therapy. These benefits were observed after 3 months of treatment. SHIFT also showed that administration of<unk>  to heart failure patients significantly reduced the risk of death from heart failure by 26% (P=0.014) and hospitalization for heart failure by 26% (P<0.0001). The improvements in outcomes were observed throughout all prespecified subgroups: female and male, with or without beta-blockers at randomization, patients below and over 65 years of age, with heart failure of ischemic or non-ischemic etiology, NYHA class II or class III, IV, with or without diabetes, and with or without hypertension. A note of caution must be emphasised.<unk> , though indicated for chronic heart failure in patients who are clinically stable, is not indicated in acute heart failure where the enhanced heart rate represents cardiac reserve. Indiscriminate use of<unk>  could destabilise these patients.
Ivabradine
Lofexidine
Setiptiline
Maprotiline
Verapamil
Nortilidine
Veratridine
Procainamide