| Title: |
Prognostic role of β‐blocker selectivity and dosage regimens in heart failure patients. Insights from the MECKI score database |
| Authors: |
Paolillo, Stefania; Mapelli, Massimo; Bonomi, Alice; Corrà, Ugo; Piepoli, Massimo; Veglia, Fabrizio; Salvioni, Elisabetta; Gentile, Piero; Lagioia, Rocco; Metra, Marco; Limongelli, Giuseppe; Sinagra, Gianfranco; Cattadori, Gaia; Scardovi, Angela B.; Carubelli, Valentina; Scrutino, Domenico; Badagliacca, Roberto; Raimondo, Rosa; Emdin, Michele; Magrì, Damiano; Correale, Michele; Parati, Gianfranco; Caravita, Sergio; Spadafora, Emanuele; Re, Federica; Cicoira, Mariantonietta; Frigerio, Maria; Bussotti, Maurizio; Minà, Chiara; Oliva, Fabrizio; Battaia, Elisa; Belardinelli, Romualdo; Mezzani, Alessandro; Pastormerlo, Luigi; Di Lenarda, Andrea; Passino, Claudio; Sciomer, Susanna; Iorio, Annamaria; Zambon, Elena; Guazzi, Marco; Pacileo, Giuseppe; Ricci, Roberto; Contini, Mauro; Apostolo, Anna; Palermo, Pietro; Clemenza, Francesco; Marchese, Giovanni; Binno, Simone; Lombardi, Carlo; Passantino, Andrea |
| Source: |
European Journal of Heart Failure ; volume 19, issue 7, page 904-914 ; ISSN 1388-9842 1879-0844 |
| Publisher Information: |
Wiley |
| Publication Year: |
2017 |
| Collection: |
Wiley Online Library (Open Access Articles via Crossref) |
| Description: |
Aims The use of β‐blockers represents a milestone in the treatment of heart failure with reduced ejection fraction ( HFrEF ). Few studies have compared β‐blockers in HFrEF , and there is little data on the effects of different doses. The present study aimed to investigate in a large database of HFrEF patients ( MECKI score database) the association of β‐blocker treatment with a composite outcome of cardiovascular death, urgent heart transplantation or left ventricular assist device implantation, addressing the role of β‐selectivity and dosage regimens. Methods and results In 5242 HFrEF patients, we investigated the role of: (i) β‐blocker treatment vs. non‐β‐blocker treatment, (ii) β1‐/β2‐receptor‐blockers vs. β1‐selective blockers, and (iii) daily β‐blocker dose. Patients were followed for 3.58 years, and 1101 events (18.3%) were observed; 4435 patients (86.8%) were on β‐blockers, while 807 (13.2%) were not. At 5 years, β‐blocker‐patients showed a better outcome than non‐β‐blocker‐subjects [hazard ratio ( HR ) 0.48, P < 0.0001], while also considering potential confounders. A comparable prognosis was observed at 5 years in the β1‐/β2‐receptor‐blocker ( n = 2219) vs. β1‐selective group ( n = 2216) ( HR 0.95, P = ns). A better prognosis was observed in high‐dose (>2 5 mg carvedilol equivalent daily dose, n = 1005) patients than in both medium dose (12.5–25 mg, n = 1431) and low dose ( |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1002/ejhf.775 |
| Availability: |
https://doi.org/10.1002/ejhf.775; https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1002%2Fejhf.775; https://onlinelibrary.wiley.com/doi/pdf/10.1002/ejhf.775 |
| Rights: |
http://onlinelibrary.wiley.com/termsAndConditions#vor |
| Accession Number: |
edsbas.ACCED19A |
| Database: |
BASE |