Dose-dependent efficacy of β-blocker in patients with chronic heart failure and atrial fibrillation

MECKI Score Research Group, Jeness Campodonico, Massimo Piepoli, Francesco Clemenza, Alice Bonomi, Stefania Paolillo, Elisabetta Salvioni, Ugo Corrà, Simone Binno, Fabrizio Veglia, Rocco Lagioia, Gianfranco Sinagra, Gaia Cattadori, Angela B Scardovi, Marco Metra, Michele Senni, Domenico Scrutinio, Rosa Raimondo, Michele Emdin, Damiano MagrìGianfranco Parati, Federica Re, Mariantonietta Cicoira, Chiara Minà, Giuseppe Limongelli, Michele Correale, Maria Frigerio, Maurizio Bussotti, Enrico Perna, Elisa Battaia, Marco Guazzi, Roberto Badagliacca, Andrea Di Lenarda, Aldo Maggioni, Claudio Passino, Susanna Sciomer, Giuseppe Pacileo, Massimo Mapelli, Carlo Vignati, Carlo Lombardi, Pasquale Perrone Filardi, Piergiuseppe Agostoni

Research output: Contribution to journalArticle

Abstract

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 
Original languageEnglish
Pages (from-to)141-146
Number of pages6
JournalInternational Journal of Cardiology
Volume273
DOIs
Publication statusPublished - Dec 15 2018

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