β-Blocker Dose More Impactful Than Heart Rate in Heart Failure
BB dose has greater impact than lower heart rate in patients with heart failure from HF-ACTION trial
MONDAY, Sept. 28, 2015 (HealthDay News) -- For patients with heart failure, higher beta-blocker (BB) dose is associated with more improvements in outcomes than lower heart rate (HR), according to a study published online Sept. 26 in JACC: Heart Failure. The research was published to coincide with the annual meeting of the Heart Failure Society of America, held from Sept. 26 to 29 in Washington, D.C.
Mona Fiuzat, Pharm.D., from Duke University and Duke Clinical Research Institute in Durham, N.C., and colleagues compared whether reduced HR or higher BB dose affected outcomes to a greater extent among 2,331 patients from the HR-ACTION trial with ambulatory heart failure and systolic dysfunction. Patients were followed for a median of 2.5 years.
The researchers found that in unadjusted analysis there was a significant inverse correlation between either BB dose (higher better), HR (lower better), and all-cause death or hospitalization; only BB dose was significant for improved mortality outcomes. Only BB dose remained significant for improved outcomes of all-cause death or hospitalization after adjustment for other predictors of outcome. In unadjusted analysis, BB dose, but not HR, correlated with improved outcomes on other cardiovascular end points; after adjustment for other predictors of outcome, the correlation did not persist.
"There were more associated improvements in outcomes with higher BB dose versus reduced HR in this well-treated heart failure cohort with systolic dysfunction," the authors write.