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Prescription of beta‐blockers in patients with advanced heart failure and preserved left ventricular ejection fraction. Clinical implications and survival
Author(s) -
Dobre Daniela,
Veldhuisen Dirk J.,
DeJongste Mike J.L.,
Lucas Carolien,
Cleuren Ger,
Sanderman Robbert,
Ranchor Adelita V.,
HaaijerRuskamp Flora M.
Publication year - 2007
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.2006.07.008
Subject(s) - medicine , heart failure , cardiology , ejection fraction , medical prescription , beta (programming language) , pharmacology , computer science , programming language
Background: The effects of β‐blockers in patients with heart failure (HF) and preserved left ventricular ejection fraction (LVEF) are not well established. Aims: To assess the association between β‐blocker prescription at discharge and mortality in a cohort of patients with advanced HF and preserved LVEF. Methods and results: We prospectively studied a cohort of 443 patients with advanced HF and preserved LVEF (LVEF≥40%). Mean age was 78years, 56% female, 33% NYHA class IV. Overall, 227 patients (51%) had a β‐blocker prescribed at discharge. Mean duration of follow‐up was 25 (±18) months. Death (all cause) occurred in 40 patients (17.6%) who were receiving a β‐blocker at discharge and 73 patients (33.8%) who were not on a β‐blocker. In multivariate Cox analysis, including adjustment for propensity score, prescription of a β‐blocker remained associated with a 43% relative mortality risk reduction (HR 0.57, 95% CI 0.37 to 0.88, p =0.01). Conclusions: In this cohort of patients with advanced HF and preserved LVEF, prescription of a β‐blocker was associated with a significant mortality reduction. This beneficial effect of β‐blocker use needs to be further confirmed in prospective, randomised clinical trials.