Drugs Linked to Survival in Some Heart Failure Patients

Beta-blockers associated with better survival in those with left ventricular systolic dysfunction

TUESDAY, Jan. 6 (HealthDay News) -- Initiating beta-blocker therapy upon hospital discharge was linked to improved survival in older heart failure patients with left ventricular systolic dysfunction, but not those with preserved systolic function, according to research published in the Jan. 13 issue of the Journal of the American College of Cardiology.

Adrian F. Hernandez, M.D., of the Duke University School of Medicine in Durham, N.C., and colleagues analyzed data from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry on 7,154 elderly patients with heart failure who were naive to beta-blockers but eligible for their use. Roughly half were started on the therapy.

In those with left ventricular systolic dysfunction, beta-blockers were associated with significantly lower mortality (adjusted hazard ratio, 0.77) and rehospitalization (adjusted hazard ratio, 0.89), the researchers report. These outcomes were not significantly lower in patients with preserved systolic function, the authors note.

"There are several possible explanations for the lack of benefit of beta-blockers in this cohort, including the heterogeneity of the population and poor understanding of pathophysiology. The single randomized trial of beta-blockers that included patients with preserved systolic function did not find a mortality benefit in the subgroup of patients with left ventricular ejection fraction of at least 40 percent. Thus, our findings among patients enrolled in the OPTIMIZE-HF registry are consistent with the existing clinical trial evidence," Hernandez and colleagues write.

GlaxoSmithKline supported this study.

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