Beta-Blockers are Associated with Decreased In-Hospital Mortality and Stroke in Acute Decompensated Heart Failure: Findings from a Retrospective Analysis of a 22-Year Registry in the Middle East (1991-2013)

Author(s): Charbel Abi Khalil, Jassim Al Suwaidi, Rajvir Singh, Nidal Asaad, Galal Abushahba, Unus Kunju, Awad Al-Qahtani, Hajar A. AlBinali.

Journal Name: Current Vascular Pharmacology

Volume 15 , Issue 1 , 2017

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Abstract:

Background: Beta-blockers reduce mortality in chronic heart failure.

Objectives: To study intra-hospital mortality and adverse cardiovascular (CV) outcomes in relation to beta-blockade therapy in acute decompensated heart failure.

Methods: We retrospectively analyzed a 22-year registry of acute decompensated heart failure (ADHF) in the Middle East.

Results: Out of the total 8066 patients admitted for ADHF, 1242(15.4%) were on beta-blockers on admission. Among those, beta-blockers were discontinued in 26.5%. Despite the existence of less CV comorbidities in patients not treated by beta-blockers, in-hospital mortality and stroke/transient ischemic attacks rates were higher in those patients compared with patients on beta-blockers on admission (14.4 vs. 3.6%, p=0.001, 0.6 vs. 0.1%, p=0.02; respectively). Additionally, continuation of beta-blockers during acute decompensation was associated with less mortality risk (p=0.001). The use of beta-blockers on admission and discharge increased significantly with time whereas in-hospital mortality decreased (p=0.001). Nevertheless, admission year was not a predictor of reduced mortality in patients treated with beta-blockers on admission (OR 0.93, 95% CI [0.56-1.54], p=0.77).

Conclusion: Previous beta-blockade therapy in patients presenting with ADHF decreases intra-hospital mortality and the incidence of CV events and stroke/transient ischemic attacks. Moreover, nonwithdrawal of beta-blockers during hospitalization has a favorable outcome.

Keywords: Acute decompensated heart failure, beta-blockers, cardiology, cardiovascular disease, heart failure, in-hospital mortality.

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Article Details

VOLUME: 15
ISSUE: 1
Year: 2017
Page: [77 - 83]
Pages: 7
DOI: 10.2174/1570161114666160822155440
Price: $58

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