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Programme to improve the use of beta‐blockers for heart failure in the elderly and in those with severe symptoms: Results of the BRING‐UP 2 Study
Author(s) -
Opasich Cristina,
Boccanelli Alessandro,
Cafiero Massimo,
Cirrincione Vincenzo,
Del Sindaco Donatella,
Di Lenarda Andrea,
Di Luzio Silvia,
Faggiano Pompilio,
Frigerio Maria,
Lucci Donata,
Porcu Maurizio,
Pulignano Giovanni,
Scherillo Marino,
Tavazzi Luigi,
Maggioni Aldo P.
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.2005.11.005
Subject(s) - carvedilol , medicine , discontinuation , heart failure , beta blocker , adverse effect , incidence (geometry) , metoprolol , cardiology , physics , optics
Background Beta‐blockers are underused in HF patients, thus strategies to implement their use are needed. Objectives To improve beta‐blocker use in elderly and/or patients with severe heart failure (HF) and to evaluate safety and outcome. Methods Patients with symptomatic HF and age ≥ 70 years or left ventricular EF < 25% and symptoms at rest were enrolled, including those already on beta‐blocker treatment. Patients who were not receiving a beta‐blocker were considered for carvedilol treatment. All patients were followed up for 1‐year. Results Of the 1518 elderly patients, 505 were already on beta‐blockers, and carvedilol was newly prescribed in 419 patients. At 1‐year, patients treated with carvedilol had a lower incidence of death [10.8% vs. 18.0% in already treated (adjusted RR 0.68; 95%CI 0.49–0.96) and 11.2% in newly treated patients (adjusted RR 0.68; 95%CI 0.48–0.97)]. Of the 709 patients with severe HF, 38.4% were already on beta‐blockers, and carvedilol was newly prescribed in 189 patients. Patients not treated with carvedilol showed the worst clinical outcome. Total rate of discontinuation (including adverse reaction and non‐compliance) was 14% and 9%, respectively, in elderly and severe patients. Conclusions In a real world setting, beta‐blocker treatment was not associated with an increased risk of adverse events in elderly and severe HF patients.