Effect of beta blocker therapy on survival of patients with heart failure and preserved systolic function following hospitalization with acute decompensated heart failure

Eur J Intern Med. 2012 Jun;23(4):374-8. doi: 10.1016/j.ejim.2012.01.011. Epub 2012 Feb 27.

Abstract

Background: The importance of heart failure with preserved ejection fraction is being increasingly recognized. However, there is a paucity of data about effective treatment for this condition. The present study investigated the impact of beta blocker therapy for 3 months before admission on the two-year survival of patients with heart failure and preserved systolic function hospitalized due to decompensated heart failure.

Methods: We performed a retrospective cohort analysis of 345 consecutive patients with heart failure with preserved systolic function older than 18 years hospitalized due to decompensated heart failure. Two groups of patients were compared: those who received beta blockers within 3 months before admission (BB) and those who did not (NBB). The primary outcome was two year all cause mortality (maximal follow-up available in all subjects). To adjust for a potential misbalance between BB and NBB groups in baseline characteristics, a propensity score for beta blocker therapy was incorporated into the survival model.

Results: 154 patients (44.6%) received beta blockers prior to admission. Overall two year mortality rate in the BB group was 50% vs. 62.8% in the NBB group, log-rank test p = 0.016. Beta blockers showed protective effect on two-year survival after adjustment for comorbidities and propensity score (hazard ratio [HR], 0.69; 95% CI 0.47-0.99).

Conclusions: Therapy with beta blockers may have protective effect on survival of patients with heart failure with preserved systolic function.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Aged
  • Aged, 80 and over
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Comorbidity
  • Female
  • Heart Failure / drug therapy*
  • Heart Failure / epidemiology
  • Heart Failure / mortality*
  • Heart Failure / physiopathology
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Propensity Score
  • Retrospective Studies
  • Stroke Volume
  • Survival Analysis
  • Systole

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors