Beta-blocker use at hospital admission beneficial in acute d
Beta-blocker use at hospital admission for acute decompensated HF was associated with lower in-hospital mortality compared with nonuse before hospitalization, researchers reported.

It remains unclear whether beta?blocker use at hospital admission is associated with better in?hospital outcomes in patients with acute decompensated heart failure.

Researchers evaluated the factors independently associated with beta?blocker use at admission, and the effect of beta?blocker use at admission on in?hospital mortality in 3817 patients with acute decompensated heart failure enrolled in the Kyoto Congestive Heart Failure registry. There were 1512 patients (39.7%) receiving, and 2305 patients (60.3%) not receiving beta?blockers at admission for the index acute decompensated heart failure hospitalization.

Factors independently associated with beta?blocker use at admission were previous heart failure hospitalization, history of myocardial infarction, atrial fibrillation, cardiomyopathy, and estimated glomerular filtration rate less than 30 mL/min per 1.73 m2. Factors independently associated with no beta?blocker use were asthma, chronic obstructive pulmonary disease, lower body mass index, dementia, older age, and left ventricular ejection fraction less than 40%. Patients on beta?blockers had significantly lower in?hospital mortality rates (4.4% versus 7.6%).

Even after adjusting for confounders, beta?blocker use at admission remained significantly associated with lower in?hospital mortality risk. Furthermore, beta?blocker use at admission was significantly associated with both lower cardiovascular mortality risk and lower noncardiovascular mortality risk. The association of beta?blocker use with lower in?hospital mortality risk was relatively more prominent in patients receiving high dose beta?blockers. The magnitude of the effect of beta?blocker use was greater in patients with previous heart failure hospitalization than in patients without.

Conclusively, Beta?blocker use at admission was associated with lower in?hospital mortality in patients with acute decompensated heart failure.

Source: https://www.ahajournals.org/doi/full/10.1161/JAHA.120.020012
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