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 Magrì; Gianfranco 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

doi:10.1016/j.ijcard.2018.08.012

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 journal › Article › peer-review

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 language	English
Pages (from-to)	141-146
Number of pages	6
Journal	International Journal of Cardiology
Volume	273
DOIs	https://doi.org/10.1016/j.ijcard.2018.08.012
Publication status	Published - Dec 15 2018

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Group, MECKI. S. R., Campodonico, J., Piepoli, M., Clemenza, F., Bonomi, A., Paolillo, S., Salvioni, E., Corrà, U., Binno, S., Veglia, F., Lagioia, R., Sinagra, G., Cattadori, G., Scardovi, A. B., Metra, M., Senni, M., Scrutinio, D., Raimondo, R., Emdin, M., ... Agostoni, P. (2018). Dose-dependent efficacy of β-blocker in patients with chronic heart failure and atrial fibrillation. International Journal of Cardiology, 273, 141-146. https://doi.org/10.1016/j.ijcard.2018.08.012

Group, MECKISR, Campodonico, J, Piepoli, M, Clemenza, F , Bonomi, A, Paolillo, S, Salvioni, E , Corrà, U, Binno, S, Veglia, F, Lagioia, R, Sinagra, G, Cattadori, G, Scardovi, AB, Metra, M, Senni, M, Scrutinio, D, Raimondo, R, Emdin, M, Magrì, D, Parati, G, Re, F, Cicoira, M, Minà, C, Limongelli, G, Correale, M, Frigerio, M, Bussotti, M, Perna, E, Battaia, E, Guazzi, M, Badagliacca, R, Di Lenarda, A, Maggioni, A, Passino, C, Sciomer, S, Pacileo, G, Mapelli, M , Vignati, C, Lombardi, C, Filardi, PP & Agostoni, P 2018, 'Dose-dependent efficacy of β-blocker in patients with chronic heart failure and atrial fibrillation', International Journal of Cardiology, vol. 273, pp. 141-146. https://doi.org/10.1016/j.ijcard.2018.08.012

@article{aacfdc3cb8fb43f5879b312cd0e8eed4,

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

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 ",

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

note = "Copyright {\textcopyright} 2018. Published by Elsevier B.V.",

year = "2018",

month = dec,

day = "15",

doi = "10.1016/j.ijcard.2018.08.012",

language = "English",

volume = "273",

pages = "141--146",

journal = "International Journal of Cardiology",

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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

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 -

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

Abstract

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