Beta-Blockers are Associated with Decreased In-Hospital Mortality and Stroke in Acute Decompensated Heart Failure: Findings from a Retrospective Analysis of a 22-Year Registry in the Middle East (1991-2013)

Title:Beta-Blockers are Associated with Decreased In-Hospital Mortality and Stroke in Acute Decompensated Heart Failure: Findings from a Retrospective Analysis of a 22-Year Registry in the Middle East (1991-2013)

Volume: 15 Issue: 1

Author(s): Charbel Abi Khalil, Jassim Al Suwaidi, Rajvir Singh, Nidal Asaad, Galal Abushahba, Unus Kunju, Awad Al-Qahtani and Hajar A. AlBinali

Affiliation:

Keywords: Acute decompensated heart failure, beta-blockers, cardiology, cardiovascular disease, heart failure, in-hospital mortality.

Abstract: Background: Beta-blockers reduce mortality in chronic heart failure.

Objectives: To study intra-hospital mortality and adverse cardiovascular (CV) outcomes in relation to beta-blockade therapy in acute decompensated heart failure.

Methods: We retrospectively analyzed a 22-year registry of acute decompensated heart failure (ADHF) in the Middle East.

Results: Out of the total 8066 patients admitted for ADHF, 1242(15.4%) were on beta-blockers on admission. Among those, beta-blockers were discontinued in 26.5%. Despite the existence of less CV comorbidities in patients not treated by beta-blockers, in-hospital mortality and stroke/transient ischemic attacks rates were higher in those patients compared with patients on beta-blockers on admission (14.4 vs. 3.6%, p=0.001, 0.6 vs. 0.1%, p=0.02; respectively). Additionally, continuation of beta-blockers during acute decompensation was associated with less mortality risk (p=0.001). The use of beta-blockers on admission and discharge increased significantly with time whereas in-hospital mortality decreased (p=0.001). Nevertheless, admission year was not a predictor of reduced mortality in patients treated with beta-blockers on admission (OR 0.93, 95% CI [0.56-1.54], p=0.77).

Conclusion: Previous beta-blockade therapy in patients presenting with ADHF decreases intra-hospital mortality and the incidence of CV events and stroke/transient ischemic attacks. Moreover, nonwithdrawal of beta-blockers during hospitalization has a favorable outcome.

Cite this article as:

Khalil Abi Charbel, Suwaidi Al Jassim, Singh Rajvir, Asaad Nidal, Abushahba Galal, Kunju Unus, Al-Qahtani Awad and AlBinali A. Hajar, Beta-Blockers are Associated with Decreased In-Hospital Mortality and Stroke in Acute Decompensated Heart Failure: Findings from a Retrospective Analysis of a 22-Year Registry in the Middle East (1991-2013), Current Vascular Pharmacology 2017; 15 (1) . https://dx.doi.org/10.2174/1570161114666160822155440