Beta-Blockers and Cardiovascular Outcomes in Acute Heart Failure with a History of Coronary Artery Disease and an Ejection Fraction ≥ 40%

Author(s): Charbel Abi Khalil*, Kadhim Sulaiman, Nidal Asaad, Khalid F. AlHabib, Alawi Alsheikh-Ali, Mohammed Jameesh, Mohammed Al-Jarallah, Bassam Bulbanat, Wael AlMahmeed, Mustafa Ridha, Nooshin Bazargani, Haitham Amin, Ahmed Al-Motarreb, Husam AlFaleh, Prashanth Panduranga, Ziyad Mahfoud, Jassim Al Suwaidi

Journal Name: Current Vascular Pharmacology

Volume 18 , Issue 6 , 2020

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Abstract:

The prognostic impact of beta-blockers (BB) in coronary artery disease (CAD) is controversial, especially in the post-reperfusion era. We studied in-hospital cardiovascular events in patients hospitalized for acute HF, a previous history of CAD and a left ventricular ejection fraction (LVEF) ≥40%, in relation to BB on admission; and 1-year outcome in relation to BB on discharge, in the GULF aCute heArt failuRe (GULF-CARE) registry. From a total of 5005 patients included in the GULF-CARE registry, 303 patients with a previous history of CAD and a LVEF ≥40% on BB were propensity-matched to 303 patients without BB on admission. In-hospital mortality (OR= 0.82; 95% CI [0.35-1.94]), stroke and cardiogenic shock were not reduced by BB. On discharge, 306 patients on BB, including the ones newly diagnosed with myocardial infarction as a precipitating cause of HF, were propensity-scored matched with 306 patients without BB. Mortality (OR= 0.86; 95%CI [0.51-1.45], hospitalization for HF or PCI/CABG at 1 year were also not reduced by BB at discharge. In summary, our data show that BB have a neutral effect on in-hospital and 1-year outcomes in acute heart failure patients with a previous history of CAD and a LVEF ≥40%.

Keywords: Heart failure, beta-blockers, left ventricular ejection fraction, mortality, cardiovascular disease, coronary artery disease.

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Article Details

VOLUME: 18
ISSUE: 6
Year: 2020
Page: [644 - 651]
Pages: 8
DOI: 10.2174/1570161118666191231114203
Price: $65

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