TY - JOUR
T1 - Does atrial fibrillation in very elderly patients with chronic systolic heart failure limit the use of carvedilol?
AU - Cioffi, Giovanni
AU - De Feo, Stefania
AU - Pulignano, Giovanni
AU - Del Sindaco, Donatella
AU - Tarantini, Luigi
AU - Stefenelli, Carlo
AU - Opasich, Cristina
PY - 2006/2/15
Y1 - 2006/2/15
N2 - Background and aims: It is well known that beta-blockers are useful in patients with chronic heart failure (CHF). These favourable effects have recently been observed even in elderly CHF patients. Objectives of the present study were to evaluate the feasibility, tolerability and safety of carvedilol therapy in a cohort of patients > 70 years of age with CHF and left ventricular ejection fraction <40% with chronic atrial fibrillation. For this purpose, we designed an observational, 12-month prospective study. Results: Among 240 patients who were referred to our centers and met inclusion criteria, 64 had chronic atrial fibrillation (27%). Thirty-nine out of these 64 subjects (61%) were treated with carvedilol, while 25 patients (39%) had contraindications to such treatment. In the cohort of 176 patients with stable sinus rhythm (control group), carvedilol could be administered in 121 patients (69%), while it was not given in 55 (31%, p = ns). Airways disease was the main reason for exclusion from carvedilol in this setting of patients. No difference in 1-year tolerability of study drug was observed among patients with chronic atrial fibrillation (29 of 33 patients = 87.9%) and stable sinus rhythm (95 of 102 = 93.1%). Adverse events leading to the discontinuation of carvedilol in these two populations were rare and never resulted in any disability, death or were life-threatening. Conclusion: In over-70 patients with systolic CHF, chronic atrial fibrillation does not limit the possibility of testing beta-blocker therapy. Carvedilol was equally tolerated and safe in patients with atrial fibrillation and sinus rhythm.
AB - Background and aims: It is well known that beta-blockers are useful in patients with chronic heart failure (CHF). These favourable effects have recently been observed even in elderly CHF patients. Objectives of the present study were to evaluate the feasibility, tolerability and safety of carvedilol therapy in a cohort of patients > 70 years of age with CHF and left ventricular ejection fraction <40% with chronic atrial fibrillation. For this purpose, we designed an observational, 12-month prospective study. Results: Among 240 patients who were referred to our centers and met inclusion criteria, 64 had chronic atrial fibrillation (27%). Thirty-nine out of these 64 subjects (61%) were treated with carvedilol, while 25 patients (39%) had contraindications to such treatment. In the cohort of 176 patients with stable sinus rhythm (control group), carvedilol could be administered in 121 patients (69%), while it was not given in 55 (31%, p = ns). Airways disease was the main reason for exclusion from carvedilol in this setting of patients. No difference in 1-year tolerability of study drug was observed among patients with chronic atrial fibrillation (29 of 33 patients = 87.9%) and stable sinus rhythm (95 of 102 = 93.1%). Adverse events leading to the discontinuation of carvedilol in these two populations were rare and never resulted in any disability, death or were life-threatening. Conclusion: In over-70 patients with systolic CHF, chronic atrial fibrillation does not limit the possibility of testing beta-blocker therapy. Carvedilol was equally tolerated and safe in patients with atrial fibrillation and sinus rhythm.
KW - Atrial fibrillation
KW - Carvedilol
KW - Elderly
KW - Heart failure
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U2 - 10.1016/j.ijcard.2005.03.028
DO - 10.1016/j.ijcard.2005.03.028
M3 - Article
C2 - 16412800
AN - SCOPUS:30444459051
VL - 107
SP - 220
EP - 224
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 2
ER -