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)

Charbel Abi Khalil, Jassim Al Suwaidi, Rajvir Singh, Nidal Asaad, Galal Abushahba, Unus Kunju, Awad Al-Qahtani, Hajar A. AlBinali

Research output: Contribution to journalArticle

2 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)77-83
Number of pages7
JournalCurrent Vascular Pharmacology
Volume15
Issue number1
DOIs
Publication statusPublished - 2017
Externally publishedYes

Fingerprint

Middle East
Hospital Mortality
Registries
Heart Failure
Stroke
Transient Ischemic Attack
Mortality
Comorbidity
Hospitalization
Myocardial Infarction
Incidence
Therapeutics

Keywords

  • Acute decompensated heart failure
  • Beta-blockers
  • Cardiology
  • Cardiovascular disease
  • Heart failure
  • In-hospital mortality

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine

Cite this

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). / Abi Khalil, Charbel; Al Suwaidi, Jassim; Singh, Rajvir; Asaad, Nidal; Abushahba, Galal; Kunju, Unus; Al-Qahtani, Awad; AlBinali, Hajar A.

In: Current Vascular Pharmacology, Vol. 15, No. 1, 2017, p. 77-83.

Research output: Contribution to journalArticle

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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)",
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.",
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T2 - Findings from a retrospective analysis of a 22-year registry in the middle east (1991-2013)

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AU - Al Suwaidi, Jassim

AU - Singh, Rajvir

AU - Asaad, Nidal

AU - Abushahba, Galal

AU - Kunju, Unus

AU - Al-Qahtani, Awad

AU - AlBinali, Hajar A.

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N2 - 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.

AB - 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.

KW - Acute decompensated heart failure

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KW - Cardiology

KW - Cardiovascular disease

KW - Heart failure

KW - In-hospital mortality

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