Beta-blockers and 1-year clinical outcomes in hospitalized heart failure patients with atrial fibrillation  

作　　者：Fu-Wei XING Li-Hua ZHANG Hai-Bo ZHANG Xue-Ke BAI Dan-Li HU Xin ZHENG Jing LI 

机构地区：[1]National Clinical Research Center for Cardiovascular Diseases,NHC Key Laboratory of Clinical Research for Cardiovascular Medications,State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,National Center for Cardiovascular Diseases,Beijing,China

出　　处：《Journal of Geriatric Cardiology》2021年第9期728-738,共11页老年心脏病学杂志（英文版）

基　　金：supported by the National Key Research and Development Program from the Ministry of Science and Technology of China(grant number:2018YFC1312400);the CAMS Innovation Fund for Medical Science(grant number:2016-I2M-2-004,2017-I2M-2-002);the National Key Technology R&D Program from the Ministry of Science and Technology of China(grant number:2015BAI12B02);the 111 Project from the Ministry of Education of China(grant number:B16005)。

摘　　要：OBJECTIVE To assess the association between beta-blockers and 1-year clinical outcomes in heart failure(HF)patients with atrial fibrillation(AF),and further explore this association that differs by left ventricular ejection fraction(LVEF)level.METHODS We enrolled hospitalized HF patients with AF from China Patient-centered Evaluative Assessment of Cardiac Events Prospective Heart Failure Study.COX proportional hazard regression models were employed to calculate hazard ratio of betablockers.The primary outcome was all-cause death.RESULTS Among 1762 HF patients with AF(756 women[41.4%]),1041(56%)received beta-blockers at discharge and 1272(72.2%)had an LVEF>40%.During one year follow up,all-cause death occurred in 305(17.3%),cardiovascular death occurred in203 patients(11.5%),and rehospitalizations for HF occurred in 622 patients(35.2%).After adjusting for demographic characteristics,social economic status,smoking status,medical history,anthropometric characteristics,and medications used at discharge,the use of beta-blockers at discharge was not associated with all-cause death[hazard ratio(HR):0.86;95%Confidence Interval(CI):0.65-1.12;P=0.256],cardiovascular death(HR:0.76,95%CI:0.52-1.11;P=0.160),or the composite outcome of all-cause death and HF rehospitalization(HR:0.97,95%CI:0.82-1.14;P=0.687)in the entire cohort.There were no significant interactions between use of beta-blockers at discharge and LVEF with respect to all-cause death,cardiovascular death,or composite outcome.In the adjusted models,the use of beta-blockers at discharge was not associated with all-cause death,cardiovascular death,or composite outcome across the different levels of LVEF:reduced(<40%),mid-range(40%-49%),or preserved LVEF(≥50%).CONCLUSION Among HF patients with AF,the use of beta-blockers at discharge was not associated with 1-year clinical outcomes,regardless of LVEF.

关 键 词：BETA-BLOCKERS and 1-year clinical outcomes in HOSPITALIZED heart failure PATIENTS with ATRIAL FIBRILLATION 

分 类 号：R541.6[医药卫生—心血管疾病] R541.75[医药卫生—内科学]