Programme to improve the use of beta-blockers for heart failure in the elderly and in those with severe symptoms: Results of the BRING-UP 2 Study

Cristina Opasich, Alessandro Boccanelli, Massimo Cafiero, Vincenzo Cirrincione, Donatella Del Sindaco, Andrea Di Lenarda, Silvia Di Luzio, Pompilio Faggiano, Maria Frigerio, Donata Lucci, Maurizio Porcu, Giovanni Pulignano, Marino Scherillo, Luigi Tavazzi, Aldo P. Maggioni

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Beta-blockers are underused in HF patients, thus strategies to implement their use are needed. Objectives: To improve beta-blocker use in elderly and/or patients with severe heart failure (HF) and to evaluate safety and outcome. Methods: Patients with symptomatic HF and age ≥ 70 years or left ventricular EF <25% and symptoms at rest were enrolled, including those already on beta-blocker treatment. Patients who were not receiving a beta-blocker were considered for carvedilol treatment. All patients were followed up for 1-year. Results: Of the 1518 elderly patients, 505 were already on beta-blockers, and carvedilol was newly prescribed in 419 patients. At 1-year, patients treated with carvedilol had a lower incidence of death [10.8% vs. 18.0% in already treated (adjusted RR 0.68; 95%CI 0.49-0.96) and 11.2% in newly treated patients (adjusted RR 0.68; 95%CI 0.48-0.97)]. Of the 709 patients with severe HF, 38.4% were already on beta-blockers, and carvedilol was newly prescribed in 189 patients. Patients not treated with carvedilol showed the worst clinical outcome. Total rate of discontinuation (including adverse reaction and non-compliance) was 14% and 9%, respectively, in elderly and severe patients. Conclusions: In a real world setting, beta-blocker treatment was not associated with an increased risk of adverse events in elderly and severe HF patients.

Original languageEnglish
Pages (from-to)649-657
Number of pages9
JournalEuropean Journal of Heart Failure
Volume8
Issue number6
DOIs
Publication statusPublished - Oct 2006

Keywords

  • Beta-blockers
  • Elderly
  • Heart failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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