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Nebivolol Effect Similar Across Ejection Fractions

Effect on primary outcome similar in elderly with preserved or impaired ejection fractions

WEDNESDAY, June 3 (HealthDay News) Beta-blockade with nebivolol appears to have a similar effect in elderly heart failure patients with and without preserved ejection fraction, according to research published in the June 9 issue of the Journal of the American College of Cardiology.

Dirk J. van Veldhuisen, M.D., of the University of Groningen in the Netherlands, and colleagues analyzed data from 2,111 patients in the Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors With Heart Failure (SENIORS) trial, which assessed the effects of the vasodilating beta-1 receptor antagonist nebivolol in patients at least 70 years of age with heart failure. Impaired ejection fraction was defined as 35 percent or below.

The researchers found that, during 21 months of follow-up, the effect of nebivolol on the primary end point -- all-cause mortality or cardiovascular hospitalizations -- was similar in patients with impaired and preserved ejection fraction. Hazard ratios for nebivolol versus placebo were 0.86 in impaired ejection fraction and 0.81 in preserved ejection fraction.

"This finding is particularly important for patients with preserved ejection fraction because no (pharmacologic) treatment has yet been shown to improve outcome in this population. Some positive data for the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are available in these patients, but the current study provides the first large-scale data for a potentially beneficial effect of beta-blockade in heart failure patients with a preserved ejection fraction, and is the only one in elderly heart failure patients. Larger, adequately powered studies with beta-blockers in this population are clearly needed," the authors conclude.

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