Efficacy of β blockers in patients with heart failure plus atrial fibrillation: an individual-patient data meta-analysis

@article{Kotecha2015EfficacyO,
  title={Efficacy of $\beta$ blockers in patients with heart failure plus atrial fibrillation: an individual-patient data meta-analysis},
  author={Dipak Kotecha and Jane Holmes and Henry Krum and Douglas G. Altman and Luis Manzano and John G. F. Cleland and Gregory Y. H. Lip and Andrew J. S. Coats and Bert Andersson and Paulus Kirchhof and Thomas G. von Lueder and Hans Wedel and Giuseppe M C Rosano and Marcelo C. Shibata and Alan C. Rigby and Marcus Flather},
  journal={The Lancet},
  year={2015},
  volume={384},
  pages={2235-2243}
}
BACKGROUND Atrial fibrillation and heart failure often coexist, causing substantial cardiovascular morbidity and mortality. β blockers are indicated in patients with symptomatic heart failure with reduced ejection fraction; however, the efficacy of these drugs in patients with concomitant atrial fibrillation is uncertain. We therefore meta-analysed individual-patient data to assess the efficacy of β blockers in patients with heart failure and sinus rhythm compared with atrial fibrillation… Expand
β-Blockers in Atrial Fibrillation Patients With or Without Heart Failure: Association With Mortality in a Nationwide Cohort Study.
TLDR
In this large nationwide cohort study, evidence of a lower mortality with β-blocker therapy in AF patients with concomitant HF was observed, and indications that β- blocker treatment is also associated with a better prognosis inAF patients without conComitant HF are observed. Expand
Should β-blockers be used in patients with heart failure and atrial fibrillation?
TLDR
It is suggested that the benefits of β-blockers are neutralized in patients with atrial fibrillation due to the induction of pauses that may impair cardiac function leading to worsening heart failure or cause arrhythmias resulting in death. Expand
β-Blockers in Atrial Fibrillation Patients With or Without Heart FailureCLINICAL PERSPECTIVE
TLDR
In this large nationwide cohort study, evidence of a lower mortality with β-blocker therapy in AF patients with concomitant HF was observed and indications that β- blocker treatment is also associated with a better prognosis inAF patients without conComitant HF are observed. Expand
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TLDR
In propensity-matched analyses, beta-blockers were associated with significantly lower mortality but not hospitalizations in patients with HFrEF and AF, irrespective of the pattern or burden of AF. Expand
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TLDR
HF patients with AF taking a β-blocker have a better outcome with a survival improvement in parallel with daily dose but no differences as regards β1 selectivity but this does not mean that β- blockers improve outcomes in these patients as they cannot control for all the potential confounders. Expand
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TLDR
No associations were found between predischarge heart rate or β-blocker dosage and clinical outcomes in patients with recent hospitalisations for HF and AF. Expand
Heart rate determines the beneficial effects of beta-blockers on cardiovascular outcomes in patients with heart failure and atrial fibrillation
TLDR
In patients with HF and Af receiving beta-blockers, low HR adversely increased the risk of cardiovascular events, and this fact may blunt the beneficial effects of beta- blockers in patients withHF and Af. Expand
The effect of beta-blockers on mortality in patients with heart failure and atrial fibrillation: A meta-analysis of observational cohort and randomized controlled studies.
TLDR
A meta-analysis suggests the potential mortality benefit of BB in patients with HF and AF and concludes that it is premature to deny patients with AF and HF BB therapy considering current evidence. Expand
Atrial fibrillation and heart failure due to reduced versus preserved ejection fraction: A systematic review and meta-analysis of death and adverse outcomes.
TLDR
All-cause mortality is significantly higher in AF patients with HFrEF compared to HFpEF, although stroke risk and heart failure hospitalization are similar, and further studies are needed to address the prevention of adverse outcomes in allAF patients with heart failure, regardless of ejection fraction. Expand
Beta-blockers and 1-year clinical outcomes in hospitalized heart failure patients with atrial fibrillation
  • F. Xing, Li-Hua ZHANG, +4 authors Jing LI
  • Medicine
  • Journal of geriatric cardiology : JGC
  • 2021
TLDR
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%). Expand
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