The Impact of Beta-Blocker Maintenance on Decompensated Heart Failure: A Systematic Review and Meta-Analysis.

IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Current Cardiology Reviews Pub Date : 2024-09-16 DOI:10.2174/011573403X291307240902071924

Luiz Fernando Leite da Silva Neto, Adriano Leitão de Almeida, Leticia Fonseca Macedo, Cauã Leal do Espírito Santo, Caio Vinicius Botelho Brito, Renato Garcia Lisboa Borges

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Abstract

Background: Acute Heart Failure (HF) is related to a significant hospital mortality rate and functional impairment in many patients. However, there is still a lack of studies that support the use of Beta-blockers (BB) in the management of decompensated HF.

Objective: This study aimed to evaluate the impact on mortality of maintaining BB in patients with decompensated HF.

Methods: A systematic review and meta-analysis was performed, using the databases PubMed, Cochrane Library, SCIELO and BVS, selecting only cohort studies and Randomized Clinical Trials (RCTs) from the last 10 years, which have been selected based on inclusion and exclusion criteria.

Results: An 86% reduction in the risk of in-hospital death was found (RR=0.14, 95% CI: 0.10- 0.18) in patients with HF who maintained the use of BB during hospitalization. A second analysis found a 44% (RR=0.56, 95% CI: 0.47-0.66) lower chance of in-hospital death in the group that previously used BB. Regarding the analysis of mortality after hospital discharge, only studies that have evaluated the use of BB in HF with reduced ejection fraction pointed to a reduction in mortality. Furthermore, some articles have found a relationship between the reduction in readmissions and the use of post-discharge BB.

Conclusion: There is still no consensus regarding the use of BB in patients hospitalized with decompensated HF. In view of the limitations of the data found in the present study, the need for more RCTs that address this topic is emphasized in order to resolve this uncertainty in the management of cardiovascular patients.

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β-受体阻滞剂维持治疗对失代偿性心力衰竭的影响：系统回顾与元分析》。

背景：急性心力衰竭（HF）与住院死亡率和许多患者的功能损害密切相关。然而，目前仍缺乏支持使用β-受体阻滞剂（BB）治疗失代偿性心力衰竭的研究：本研究旨在评估对失代偿性高血压患者维持使用BB对死亡率的影响：利用PubMed、Cochrane Library、SCIELO和BVS等数据库进行了系统回顾和荟萃分析，仅选择了过去10年中的队列研究和随机临床试验（RCT），并根据纳入和排除标准进行了筛选：结果发现，住院期间坚持使用 BB 的高血压患者院内死亡风险降低了 86%（RR=0.14，95% CI：0.10-0.18）。第二项分析发现，之前使用过BB的一组患者的院内死亡几率降低了44%（RR=0.56，95% CI：0.47-0.66）。关于出院后死亡率的分析，只有对射血分数降低的 HF 使用 BB 进行评估的研究指出死亡率有所降低。此外，一些文章还发现，再入院率的降低与出院后使用BB有一定关系：结论：对于失代偿性心房颤动住院患者使用BB治疗仍未达成共识。鉴于本研究中发现的数据存在局限性，我们强调需要更多针对这一主题的研究性试验，以解决心血管患者管理中的这一不确定性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Cardiology Reviews CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.70

自引率

10.50%

发文量

117

期刊介绍： Current Cardiology Reviews publishes frontier reviews of high quality on all the latest advances on the practical and clinical approach to the diagnosis and treatment of cardiovascular disease. All relevant areas are covered by the journal including arrhythmia, congestive heart failure, cardiomyopathy, congenital heart disease, drugs, methodology, pacing, and preventive cardiology. The journal is essential reading for all researchers and clinicians in cardiology.