Impact of Renal Impairment on Beta-Blocker Efficacy in Patients With Heart Failure.
Adrenergic beta-Antagonists
/ therapeutic use
Aged
Cause of Death
/ trends
Comorbidity
Disease Progression
Double-Blind Method
Female
Glomerular Filtration Rate
/ drug effects
Heart Failure
/ drug therapy
Humans
Male
Middle Aged
Prognosis
Renal Insufficiency
/ epidemiology
Stroke Volume
/ drug effects
Survival Rate
/ trends
Ventricular Function, Left
/ drug effects
beta-blockers
heart failure
mortality
renal impairment
Journal
Journal of the American College of Cardiology
ISSN: 1558-3597
Titre abrégé: J Am Coll Cardiol
Pays: United States
ID NLM: 8301365
Informations de publication
Date de publication:
10 12 2019
10 12 2019
Historique:
received:
30
08
2019
revised:
11
09
2019
accepted:
16
09
2019
entrez:
7
12
2019
pubmed:
7
12
2019
medline:
22
5
2020
Statut:
ppublish
Résumé
Moderate and moderately severe renal impairment are common in patients with heart failure and reduced ejection fraction, but whether beta-blockers are effective is unclear, leading to underuse of life-saving therapy. This study sought to investigate patient prognosis and the efficacy of beta-blockers according to renal function using estimated glomerular filtration rate (eGFR). Analysis of 16,740 individual patients with left ventricular ejection fraction <50% from 10 double-blind, placebo-controlled trials was performed. The authors report all-cause mortality on an intention-to-treat basis, adjusted for baseline covariates and stratified by heart rhythm. Median eGFR at baseline was 63 (interquartile range: 50 to 77) ml/min/1.73 m Patients with heart failure, left ventricular ejection fraction <50% and sinus rhythm should receive beta-blocker therapy even with moderate or moderately severe renal dysfunction.
Sections du résumé
BACKGROUND
Moderate and moderately severe renal impairment are common in patients with heart failure and reduced ejection fraction, but whether beta-blockers are effective is unclear, leading to underuse of life-saving therapy.
OBJECTIVES
This study sought to investigate patient prognosis and the efficacy of beta-blockers according to renal function using estimated glomerular filtration rate (eGFR).
METHODS
Analysis of 16,740 individual patients with left ventricular ejection fraction <50% from 10 double-blind, placebo-controlled trials was performed. The authors report all-cause mortality on an intention-to-treat basis, adjusted for baseline covariates and stratified by heart rhythm.
RESULTS
Median eGFR at baseline was 63 (interquartile range: 50 to 77) ml/min/1.73 m
CONCLUSIONS
Patients with heart failure, left ventricular ejection fraction <50% and sinus rhythm should receive beta-blocker therapy even with moderate or moderately severe renal dysfunction.
Identifiants
pubmed: 31806133
pii: S0735-1097(19)37932-X
doi: 10.1016/j.jacc.2019.09.059
pii:
doi:
Substances chimiques
Adrenergic beta-Antagonists
0
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2893-2904Subventions
Organisme : Department of Health
ID : CDF-2015-08-074
Pays : United Kingdom
Commentaires et corrections
Type : CommentIn
Type : ErratumIn
Type : CommentIn
Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.