β-Blockade in Heart Failure With Reduced Ejection Fraction: Does Heart Rate Control Influence Readmissions?
| Autor: | Abdulrahman Alshaya, Jennifer D. Twilla, Carolyn Cummings, Timothy H. Self, Ryan E. Owens, Carlvin J. Metra, Carrie S. Oliphant |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Beats per minute Adrenergic beta-Antagonists 030204 cardiovascular system & hematology Patient Readmission β blockade 03 medical and health sciences 0302 clinical medicine Heart Rate Internal medicine Heart rate medicine Humans Pharmacology (medical) In patient 030212 general & internal medicine Risk factor Aged Retrospective Studies Heart Failure Ejection fraction business.industry Stroke Volume Middle Aged medicine.disease Treatment Outcome Heart failure Cardiology Female business Cardiovascular outcomes |
| Zdroj: | Journal of pharmacy practice. 31(1) |
| ISSN: | 1531-1937 |
| Popis: | Background: Raised resting heart rate (HR), >70 beats per minute (bpm), has been shown to be a risk factor for adverse cardiovascular outcomes and hospital readmissions, specifically in patients with heart failure with reduced ejection fraction (HF rEF). Given their mortality benefit, β-blockers are recommended in HF rEF, with a goal to titrate to a maximum tolerated dose rather than a specific HR target. Objective: To determine the impact of optimal HR control achievement prior to hospital discharge on hospital readmissions in patients with HF rEF receiving β-blockade. Methods: A retrospective study of patients admitted to 5 adult hospitals within a large urban health-care system, between 2013 and 2015, was conducted. Patients were identified via International Classification of Diseases, Ninth Revision ( ICD-9) coding for acute on chronic HF rEF. Results: Of the 225 patients included, 20% achieved optimal HR control (n = 46, HR .99) and ED visits (11% vs 8%, respectively; P = .57). Conclusions: Readmission rates were similar among patients with HF rEF despite the majority failing to achieve optimal HR control from β-blockade. However, β-blocker dosing remains suboptimal relative to guideline-recommended target doses. Opportunities exist for inpatient clinicians to optimize β-blockade in an attempt to achieve HR control. |
| Databáze: | OpenAIRE |
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