β-Blockers on Discharge From Acute Atrial Fibrillation Are Associated With Decreased Mortality and Lower Cerebrovascular Accidents in Patients With Heart Failure and Reduced Ejection Fraction

Charbel Abi Khalil, Mohammad Zubaid, Nidal Asaad, Wafa A. Rashed, Adel Khalifa Hamad, Rajvir Singh, Jassim Al Suwaidi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The benefits of β-blockers in patients with heart failure (HF) with reduced ejection fraction (HFrEF) and atrial fibrillation (AF) are controversial. The Gulf Survey of Atrial Fibrillation Events was a prospective, multinational, observational registry of consecutive patients with AF recruited from the emergency department (ED). We studied the incidence of 6- and 12-month mortality, hospitalization for HF or AF, and stroke/transient ischemic attacks (TIAs) in patients with HFrEF, in relation to β-blockers on discharge from the ED or the subsequent hospital stay. Of the 344 patients with HFrEF and AF in the GULF-SAFE, 177 patients (53%) were discharged on β-blockers. Mortality was lower in those patients compared with the non-β-blockers group at 6 and 12 months (odds ratios [ORs] 0.31, 95% CI [0.16-0.61]; OR 0.30, 95% CI [0.16-0.55]; P =.001 for both, respectively), so was the risk of stroke/TIAs. However, hospitalizations for AF increased in the β-blockers group. Even after adjustment for several risk variables in 2 different models, the beneficial effect of β-blockers on mortality persisted, at the cost of more hospitalization for AF.

Original languageEnglish
Pages (from-to)316-322
Number of pages7
JournalAngiology
Volume69
Issue number4
DOIs
Publication statusPublished - 1 Apr 2018

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Keywords

  • atrial fibrillation
  • cardiovascular mortality
  • heart failure
  • stroke
  • β-blockers

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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