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Effect of beta‐blocker therapy on functional status in patients with heart failure — A meta‐analysis
Author(s) -
Abdulla Jawdat,
Køber Lars,
Christensen Erik,
TorpPedersen Christian
Publication year - 2006
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2005.10.012
Subject(s) - medicine , heart failure , placebo , meta analysis , odds ratio , randomized controlled trial , cardiology , vo2 max , beta blocker , beta (programming language) , drug class , heart rate , pharmacology , drug , blood pressure , alternative medicine , pathology , computer science , programming language
Abstract Background: The results of randomised control trials (RCTs) evaluating the effect of beta‐blockers on functional status in patients with chronic heart failure are conflicting. Aim: To perform a systematic review and meta‐analysis of RCTs evaluating the effect of beta‐blockers on New York Heart Association (NYHA) classification and exercise tolerance in chronic heart failure. Methods and results We selected 28 RCTs evaluating beta‐blocker versus placebo in addition to ACE inhibitor therapy. Combined results of 23 RCTs showed that beta‐blockers improved NYHA class by at least one class with odds ratio (OR) 1.80 (1.33–2.43) p <0.0001. Meta‐analysis of 10 RCTs showed a significant prolongation of exercise time by 44.19 (6.62–81.75) s p =0.021. Combining 8 RCTs evaluating the maximal peak oxygen uptake and 9 RCTs evaluating 6‐min walk distance showed that beta‐blockers had no significant effect compared with placebo, p =0.484, and p =0.730, respectively. Combined results of the 23 RCTs showed significant reducing effect on all cause mortality with OR=0.69 (0.59–0.82) p <0.0001. Conclusion: Chronic use of a beta‐blocker in conjunction with ACE inhibitor therapy improves dyspnoea and prolongs exercise tolerance time, but has no significant effect on 6‐min walk test or maximal oxygen uptake in patients with heart failure.