Beta-Blockers May Reduce Death Risk in HFrEF, A-Fib

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With respect to mortality and hospitalizations, there were no significant interactions for β-blockers and pattern or burden of AF.
With respect to mortality and hospitalizations, there were no significant interactions for β-blockers and pattern or burden of AF.

(HealthDay News) — β-blockers are associated with significantly reduced mortality, but not hospitalizations, in patients with heart failure and reduced ejection fraction (HFrEF) and atrial fibrillation (AF), according to a study published online in JACC: Heart Failure.

Julia Cadrin-Tourigny, MD, from the Université de Montréal, and colleagues examined the impact of β-blockers on mortality and hospitalizations in patients with AF and HFrEF in the AF-CHF trial. Among 1376 subjects randomized in the trial, the authors propensity-matched those without β-blockers at baseline to a maximum of 2 exposed patients.

The researchers found that β-blockers correlated with significantly lower all-cause mortality (hazard ratio [HR], 0.721; 95% confidence interval [CI], 0.549 to 0.945; P = 0.0180) but not hospitalizations (HR, 0.886; 95% CI, 0.715 to 1.100; P = 0.2232) during a median follow-up of 37 months. In sensitivity analyses that modeled β-blockers as a time-dependent variable the results were similar (HR for all-cause mortality, 0.668; 95% CI, 0.511 to 0.874; P = 0.0032; HR for hospitalizations, 0.814; 95% CI, 0.653 to 1.014; P = 0.0658). With respect to mortality and hospitalizations, there were no significant interactions for β-blockers and pattern or burden of AF.

"These results support current evidence-based recommendations for β-blockers in patients with HFrEF, whether or not they have associated AF," the authors write.

Reference

  1. Cadrin-Tourigny J, Shohoudi A, Roy D, et al. Decreased Mortality With Beta-Blockers in Patients With Heart Failure and Coexisting Atrial Fibrillation. JACC.  January 2017.  DOI: 10.1016/j.jchf.2016.10.015

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