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Continuing Drug Reduces Death After Heart Failure

Reduced mortality compared with patients who withdraw from beta-blockers or do not receive treatment

WEDNESDAY, July 9 (HealthDay News) -- Patients hospitalized for heart failure who continue to receive beta-blocker therapy after discharge have a lower risk of death than patients who withdraw from treatment or do not receive treatment, researchers report in the July 15 issue of the Journal of the American College of Cardiology.

Gregg C. Fonarow, M.D., from the University of California Los Angeles Medical Center, and colleagues examined outcomes in patients hospitalized with systolic heart failure. Of 2,373 patients eligible for beta-blockers at discharge, 56.9 percent continued treatment begun before hospitalization, 26.6 percent started treatment, 3.3 percent withdrew from treatment, and 12.8 percent were not treated.

After 60 to 90 days of follow-up, the researchers found that continuing beta-blocker treatment significantly lowered the risk of post-discharge death (hazard ratio 0.60) and death or rehospitalization (HR, 0.69) compared with no beta-blocker treatment. Withdrawal from beta-blocker treatment significantly increased the risk of mortality compared with those who continued treatment (HR, 2.3), although they had similar death and rehospitalization rates as continuing patients and a similar risk of heart failure as patients who did not receive treatment.

"The continuation of beta-blocker therapy in patients hospitalized with decompensated heart failure is associated with lower post-discharge mortality risk and improved treatment rates," Fonarow and colleagues conclude. "In contrast, withdrawal of beta-blocker therapy is associated with worse risk and propensity-adjusted mortality."

The study was funded by GlaxoSmithKline.

Abstract
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