Beta-blocker therapy in elderly patients with renal dysfunction and heart failure  

作　　者：Juan Martínez-Milla Marcelino Cortés García Julia Anna Palfy Mikel Taibo Urquía Marta López Castillo Ana Devesa Arbiol Ana Lucía Rivero Monteagudo María Luisa Martín Mariscal Inés Jiménez-Varas Sem Briongos Figuero Juan Antonio Franco-Pelaéz JoséTuñón 

机构地区：[1]Department of Cardiology,Hospital Universitario Fundación Jiménez Díaz-Quirónsalud [2]Centro Nacional de Investigaciones Cardiovasculares,Madrid,Spain [3]Department of Cardiology,Hospital Central de Asturias [4]Department of Cardiology,Hospital Universitario Ruber-Quirónsalud [5]Department of Cardiology,Hospital Universitario Infanta Leonor [6]Department of Endocrinology,Hospital Clínico San Carlos [7]Universidad Autónoma de Madrid [8]CIBERCV,Madrid,Spain

出　　处：《Journal of Geriatric Cardiology》2021年第1期20-29,共10页老年心脏病学杂志（英文版）

摘　　要：OBJECTIVE To assess the role of beta-blockers(BB)in patients with chronic kidney disease(CKD)aged≥75 years.METHODS AND RESULTS From January 2008 to July 2014,we included 390 consecutive patients≥75 years of age with ejection fraction≤35%and glomerular filtration rate(GFR)≤60 m L/min per 1.73 m^2.We analyzed the relationship between treatment with BB and mortality or cardiovascular events.The mean age of our population was 82.6±4.1 years.Mean ejection fraction was 27.9%±6.5%.GFR was 60-45 m L/min per 1.73 m^2 in 50.3%of patients,45-30 m L/min per 1.73 m^2 in 37.4%,and<30 m L/min per 1.73 m^2 in 12.3%.At the conclusion of follow-up,67.4%of patients were receiving BB.The median follow-up was28.04(IR:19.41-36.67)months.During the study period,211 patients(54.1%)died and 257(65.9%)had a major cardiovascular event(death or hospitalization for heart failure).BB use was significantly associated with a reduced risk of death(HR=0.51,95%CI:0.35-0.74;P<0.001).Patients receiving BB consistently showed a reduced risk of death across the different stages of CKD:stage IIIa(GFR=30-45 m L/min per 1.73 m^2;HR=0.47,95%CI:0.26-0.86,P<0.0001),stage IIIb(GFR 30-45 m L/min per 1.73 m^2;HR=0.55,95%CI:0.26-1.06,P=0.007),and stages IV and V(GFR<30 m L/min per 1.73 m~2;HR=0.29,95%CI:0.11-0.76;P=0.047).CONCLUSIONS The use of BB in elderly patients with HFr EF and renal impairment was associated with a better prognosis.Use of BB should be encouraged when possible.

关 键 词：CKD GFR Beta-blocker therapy in elderly patients with renal dysfunction and heart failure 

分 类 号：R541.6[医药卫生—心血管疾病] R692[医药卫生—内科学]