AIMS: The effects of beta-blockers in daily practice patients with advanced chronic heart failure (CHF) and a broad range of ejection fraction (EF) are not well established. We aimed to assess, first, the association between beta-blocker prescription at discharge and mortality in a cohort of patients with advanced CHF, and second, whether this association is modified by the age of the patient. METHODS: Patients diagnosed with advanced CHF (n = 625) were prospectively followed after discharge from the Cardiology Department. The mean age was 76 years, 53% male, mean EF 42 +/- 16%. Overall, 308 (49%) patients had a beta-blocker prescribed at discharge, 140 (22%) low-dose and 168 (27%) high-dose therapy. We used multivariate Cox analysis to assess the association between beta-blocker use at discharge and mortality. RESULTS: After a mean follow-up of 22 months, 117 (27%) patients died. Prescription of a beta-blocker was associated with a 45% relative risk reduction (hazard ratio 0.55, 95% confidence interval 0.39, 0.78). The relative risk reduction was similar with low and high doses of beta-blockers (42% and 49%). However, the relative risk reduction was higher in younger than in older patients (P = 0.006). In patients < or = 75 years old prescription of a beta-blocker was associated with 71% risk reduction, whereas in patients >75 years old it was associated with 21% risk reduction. CONCLUSIONS: In this daily practice cohort of patients with advanced CHF, prescription of a beta-blocker was associated with significant mortality reduction. However, the beneficial effects of beta-blockers appear to be greater in younger patients.
AIMS: The effects of beta-blockers in daily practice patients with advanced chronic heart failure (CHF) and a broad range of ejection fraction (EF) are not well established. We aimed to assess, first, the association between beta-blocker prescription at discharge and mortality in a cohort of patients with advanced CHF, and second, whether this association is modified by the age of the patient. METHODS:Patients diagnosed with advanced CHF (n = 625) were prospectively followed after discharge from the Cardiology Department. The mean age was 76 years, 53% male, mean EF 42 +/- 16%. Overall, 308 (49%) patients had a beta-blocker prescribed at discharge, 140 (22%) low-dose and 168 (27%) high-dose therapy. We used multivariate Cox analysis to assess the association between beta-blocker use at discharge and mortality. RESULTS: After a mean follow-up of 22 months, 117 (27%) patients died. Prescription of a beta-blocker was associated with a 45% relative risk reduction (hazard ratio 0.55, 95% confidence interval 0.39, 0.78). The relative risk reduction was similar with low and high doses of beta-blockers (42% and 49%). However, the relative risk reduction was higher in younger than in older patients (P = 0.006). In patients < or = 75 years old prescription of a beta-blocker was associated with 71% risk reduction, whereas in patients >75 years old it was associated with 21% risk reduction. CONCLUSIONS: In this daily practice cohort of patients with advanced CHF, prescription of a beta-blocker was associated with significant mortality reduction. However, the beneficial effects of beta-blockers appear to be greater in younger patients.
Authors: P Lechat; J S Hulot; S Escolano; A Mallet; A Leizorovicz; M Werhlen-Grandjean; G Pochmalicki; H Dargie Journal: Circulation Date: 2001-03-13 Impact factor: 29.690
Authors: Marcus D Flather; Marcelo C Shibata; Andrew J S Coats; Dirk J Van Veldhuisen; Aleksandr Parkhomenko; Joszef Borbola; Alain Cohen-Solal; Dan Dumitrascu; Roberto Ferrari; Philippe Lechat; Jordi Soler-Soler; Luigi Tavazzi; Lenka Spinarova; Jiri Toman; Michael Böhm; Stefan D Anker; Simon G Thompson; Philip A Poole-Wilson Journal: Eur Heart J Date: 2005-01-09 Impact factor: 29.983
Authors: C R Benedict; D H Weiner; D E Johnstone; M G Bourassa; J K Ghali; J Nicklas; P Kirlin; B Greenberg; M A Quinones; S Yusuf Journal: J Am Coll Cardiol Date: 1993-10 Impact factor: 24.094
Authors: H Krum; J D Sackner-Bernstein; R L Goldsmith; M L Kukin; B Schwartz; J Penn; N Medina; M Yushak; E Horn; S D Katz Journal: Circulation Date: 1995-09-15 Impact factor: 29.690
Authors: Christopher J Rush; Ross T Campbell; Pardeep S Jhund; Mark C Petrie; John J V McMurray Journal: Eur Heart J Date: 2018-10-01 Impact factor: 29.983