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)
| Autor: | Jassim Al Suwaidi, Unus Kunju, Rajvir Singh, Galal Abushahba, Hajar A. AlBinali, Charbel Abi Khalil, Nidal Asaad, Awad Al-Qahtani |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Acute decompensated heart failure Adrenergic beta-Antagonists 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Odds Ratio Humans Medicine Decompensation Hospital Mortality Registries 030212 general & internal medicine Qatar Stroke Aged Retrospective Studies Heart Failure Pharmacology Chi-Square Distribution business.industry Incidence (epidemiology) Retrospective cohort study Odds ratio Middle Aged medicine.disease Logistic Models Treatment Outcome Heart failure Multivariate Analysis Cardiology Female Cardiology and Cardiovascular Medicine business Chi-squared distribution |
| Zdroj: | Current Vascular Pharmacology. 15:77-83 |
| ISSN: | 1570-1611 |
| DOI: | 10.2174/1570161114666160822155440 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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