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

[ Vol. 18 , Issue. 6 ]

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 and Jassim Al Suwaidi   Pages 644 - 651 ( 8 )

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.

Affiliation:

Heart Hospital, Hamad Medical Corporation, Doha, National Heart Center, Royal Hospital, Muscat, Heart Hospital, Hamad Medical Corporation, Doha, Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, College of Medicine Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, Heart Hospital, Hamad Medical Corporation, Doha, Department of Cardiology, Sabah Al-Ahmed Cardiac Center, Kuwait City, Department of Medicine, Al-Amiri Hospital, Kuwait City, Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, Department of Cardiology, Adan Hospital, Kuwait City, Department of Cardiology, Dubai Hospital, Dubai, Department of Cardiology, Mohammed Bin Khalifa Cardiac Center, Manamah, Department of Cardiology, Faculty of Medicine, Sana’a University, Sana’a, Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, National Heart Center, Royal Hospital, Muscat, Biostatistics, Epidemiology and BioMathematical Research Core, Doha, Heart Hospital, Hamad Medical Corporation, Doha

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