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β-blockers may be detrimental in frail patients with heart failure with preserved ejection fraction.
- Source :
-
Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2024 Jun; Vol. 113 (6), pp. 842-855. Date of Electronic Publication: 2023 Nov 29. - Publication Year :
- 2024
-
Abstract
- Background: The effectiveness of β-blocker in patients with heart failure with preserved ejection fraction (HFpEF) remains to be determined. We aimed to clarify the association between the use of β-blocker and prognosis according to the status of frailty.<br />Methods: We compared prognosis between HFpEF patients with and without β-blockers stratified with the Clinical Frailty Scale (CFS), using data from the PURSUIT-HFpEF registry (UMIN000021831).<br />Results: Among 1159 patients enrolled in the analysis (median age, 81.4 years; male, 44.7%), 580 patients were CFS ≤ 3, while 579 were CFS ≥ 4. Use of β-blockers was associated with a worse composite endpoint of all-cause death and heart failure readmission in patients with CFS ≥ 4 (adjusted hazard ratio (HR) 1.43, 95% CI 1.10-1.85, p = 0.007), but was not significantly associated with this endpoint in those with CFS ≤ 3 (adjusted HR 0.95, 95% CI 0.71-1.26, p = 0.719) in multivariable Cox proportional hazard models. These results were confirmed in a propensity-matched analysis (HR in those with CFS ≥ 4: 1.42, 95% CI 1.05-1.90, p = 0.020; that in those with CFS ≤ 3: 0.83, 95% CI 0.60-1.14, p = 0.249), and in an analysis in which patients were divided into CFS ≤ 4 and CFS ≥ 5.<br />Conclusions: Use of β-blockers was significantly associated with worse prognosis specifically in patients with HFpEF and high CFS, but not in those with low CFS. Use of β-blockers in HFpEF patients with frailty may need careful attention.<br /> (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
- Subjects :
- Humans
Male
Female
Aged, 80 and over
Aged
Prognosis
Frailty
Risk Factors
Ventricular Function, Left drug effects
Ventricular Function, Left physiology
Japan epidemiology
Cause of Death trends
Heart Failure drug therapy
Heart Failure physiopathology
Heart Failure mortality
Heart Failure complications
Adrenergic beta-Antagonists therapeutic use
Stroke Volume physiology
Stroke Volume drug effects
Registries
Frail Elderly
Subjects
Details
- Language :
- English
- ISSN :
- 1861-0692
- Volume :
- 113
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Clinical research in cardiology : official journal of the German Cardiac Society
- Publication Type :
- Academic Journal
- Accession number :
- 38019285
- Full Text :
- https://doi.org/10.1007/s00392-023-02301-5