TY - JOUR
T1 - Dose-dependent efficacy of β-blocker in patients with chronic heart failure and atrial fibrillation
AU - Group, MECKI Score Research
AU - Campodonico, Jeness
AU - Piepoli, Massimo
AU - Clemenza, Francesco
AU - Bonomi, Alice
AU - Paolillo, Stefania
AU - Salvioni, Elisabetta
AU - Corrà, Ugo
AU - Binno, Simone
AU - Veglia, Fabrizio
AU - Lagioia, Rocco
AU - Sinagra, Gianfranco
AU - Cattadori, Gaia
AU - Scardovi, Angela B
AU - Metra, Marco
AU - Senni, Michele
AU - Scrutinio, Domenico
AU - Raimondo, Rosa
AU - Emdin, Michele
AU - Magrì, Damiano
AU - Parati, Gianfranco
AU - Re, Federica
AU - Cicoira, Mariantonietta
AU - Minà, Chiara
AU - Limongelli, Giuseppe
AU - Correale, Michele
AU - Frigerio, Maria
AU - Bussotti, Maurizio
AU - Perna, Enrico
AU - Battaia, Elisa
AU - Guazzi, Marco
AU - Badagliacca, Roberto
AU - Di Lenarda, Andrea
AU - Maggioni, Aldo
AU - Passino, Claudio
AU - Sciomer, Susanna
AU - Pacileo, Giuseppe
AU - Mapelli, Massimo
AU - Vignati, Carlo
AU - Lombardi, Carlo
AU - Filardi, Pasquale Perrone
AU - Agostoni, Piergiuseppe
N1 - Copyright © 2018. Published by Elsevier B.V.
PY - 2018/12/15
Y1 - 2018/12/15
N2 - BACKGROUND: The usefulness of β-blockers in heart failure (HF) patients with permanent atrial fibrillation (AF) has been questioned.METHODS AND RESULTS: We analyzed data from HF patients (958 patients (801 males, 84%, age 67 ± 11 years)) with AF enrolled in the MECKI score database. We evaluated prognosis (composite of cardiovascular death, urgent heart transplant, or left ventricular assist device) of patients receiving β-blockers (n = 777, 81%) vs. those not treated with β-blockers (n = 181, 19%). We also analyzed the role β1-selectivity and the role of daily β-blocker dose. To account for different HF severity, Kaplan-Meier survival curves were normalized for relevant confounding factors and for treatment strategies. Dose was available in 629 patients. Median follow-up was 1312 (577-2304) days in the entire population, 1203 (614-2420) and 1325 (569-2300) days in patients not receiving and receiving β-blockers. 224 (23%, 54/1000 events/year), 163 (21%, 79/1000 events/year), and 61 (34%, 49/1000 events/year) events were recorded, respectively. At 10-year patients treated with β-blockers had a better outcome (HR 0.447, p
AB - BACKGROUND: The usefulness of β-blockers in heart failure (HF) patients with permanent atrial fibrillation (AF) has been questioned.METHODS AND RESULTS: We analyzed data from HF patients (958 patients (801 males, 84%, age 67 ± 11 years)) with AF enrolled in the MECKI score database. We evaluated prognosis (composite of cardiovascular death, urgent heart transplant, or left ventricular assist device) of patients receiving β-blockers (n = 777, 81%) vs. those not treated with β-blockers (n = 181, 19%). We also analyzed the role β1-selectivity and the role of daily β-blocker dose. To account for different HF severity, Kaplan-Meier survival curves were normalized for relevant confounding factors and for treatment strategies. Dose was available in 629 patients. Median follow-up was 1312 (577-2304) days in the entire population, 1203 (614-2420) and 1325 (569-2300) days in patients not receiving and receiving β-blockers. 224 (23%, 54/1000 events/year), 163 (21%, 79/1000 events/year), and 61 (34%, 49/1000 events/year) events were recorded, respectively. At 10-year patients treated with β-blockers had a better outcome (HR 0.447, p
U2 - 10.1016/j.ijcard.2018.08.012
DO - 10.1016/j.ijcard.2018.08.012
M3 - Article
VL - 273
SP - 141
EP - 146
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -