BACKGROUND: The effect of treatment with β-blockers on the prognosis of patients newly diagnosed with heart failure with preserved ejection fraction (HFpEF) is unknown. OBJECTIVE: To analyze the relationship of commencing treatment with the β-blockers bisoprolol or carvedilol (CT-βB) with the prognosis of newly diagnosed HFpEF. METHODS: Prospective study over 10years on 2704 patients with HFpEF. Main outcomes were mortality (all-cause and cardiovascular), hospitalizations for HF worsening, and visits. The independent relationship between CT-βB and the prognosis, stratifying patients for cardiovascular co-morbidity after propensity score-matching (985 patients CT-βB vs. another 985 patients non-CT-βB), was analyzed. RESULTS: During a median follow-up of 1877.4days (interquartile range, 1-3651.2) 1600 died (81.2%), and 1702 were hospitalized (86.4%). CT-βB was associated with a lower risk of mortality (all-cause: HR [CI 95%] 0.78 [0.71 to 0.85], and cardiovascular: 0.75 [0.69 to 0.82]), a lower hospitalization rate (per 100 persons-year), 15.8 vs. 19.2, and a lower 30-day readmission rate (per 100 persons-year), 4.0 vs. 5.8, (P<0.001 in all cases), even after adjustment for the propensity to take β-blockers or other medications, comorbidities, and other potential confounders. These effects of CT-βB were independent of gender, and were observed in both patients taking high dose βB (over the median dose) and lower dose βB (under or equal to the median dose). CONCLUSIONS: In this propensity matched study, commencing treatment with bisoprolol or carvedilol, both at high and at lower doses, is associated with an improved prognosis of patients newly diagnosed with HFpEF.
BACKGROUND: The effect of treatment with β-blockers on the prognosis of patients newly diagnosed with heart failure with preserved ejection fraction (HFpEF) is unknown. OBJECTIVE: To analyze the relationship of commencing treatment with the β-blockers bisoprolol or carvedilol (CT-βB) with the prognosis of newly diagnosed HFpEF. METHODS: Prospective study over 10years on 2704 patients with HFpEF. Main outcomes were mortality (all-cause and cardiovascular), hospitalizations for HF worsening, and visits. The independent relationship between CT-βB and the prognosis, stratifying patients for cardiovascular co-morbidity after propensity score-matching (985 patients CT-βB vs. another 985 patients non-CT-βB), was analyzed. RESULTS: During a median follow-up of 1877.4days (interquartile range, 1-3651.2) 1600 died (81.2%), and 1702 were hospitalized (86.4%). CT-βB was associated with a lower risk of mortality (all-cause: HR [CI 95%] 0.78 [0.71 to 0.85], and cardiovascular: 0.75 [0.69 to 0.82]), a lower hospitalization rate (per 100 persons-year), 15.8 vs. 19.2, and a lower 30-day readmission rate (per 100 persons-year), 4.0 vs. 5.8, (P<0.001 in all cases), even after adjustment for the propensity to take β-blockers or other medications, comorbidities, and other potential confounders. These effects of CT-βB were independent of gender, and were observed in both patients taking high dose βB (over the median dose) and lower dose βB (under or equal to the median dose). CONCLUSIONS: In this propensity matched study, commencing treatment with bisoprolol or carvedilol, both at high and at lower doses, is associated with an improved prognosis of patients newly diagnosed with HFpEF.
Authors: Julian C Dunkley; Camila I Irion; Keyvan Yousefi; Serene A Shehadeh; Guerline Lambert; Krista John-Williams; Keith A Webster; Jeffrey J Goldberger; Lina A Shehadeh Journal: Am J Physiol Heart Circ Physiol Date: 2021-03-26 Impact factor: 4.733
Authors: Sean Lee Zheng; Fiona T Chan; Adam A Nabeebaccus; Ajay M Shah; Theresa McDonagh; Darlington O Okonko; Salma Ayis Journal: Heart Date: 2017-08-05 Impact factor: 5.994
Authors: Sara Maldonado-Martín; Peter H Brubaker; Cemal Ozemek; Jon A Jayo-Montoya; J Thomas Becton; Dalane W Kitzman Journal: J Cardiopulm Rehabil Prev Date: 2020-05 Impact factor: 3.646
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