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Beta-blockers do not reduce cardiovascular events in patients with CAD and an LVEF > 40%: A propensity-score matched analysis of patients hospitalized for acute heart failure

Session Poster Session 1

Speaker Associate Professor Charbel Abi Khalil

Congress : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Acute Heart Failure - Epidemiology, Prognosis, Outcome
  • Session type : Poster Session
  • FP Number : P490

Authors : C Abi Khalil (Doha,QA), K Sulaiman (Muscat,OM), N Asaad (Doha,QA), K Alhabib (Riyadh,SA), A Alsheikh-Ali (Dubai,AE), M Jameesh (Doha,QA), M Al-Jarallah (Kuwait,KW), B Bulbanat (Kuwait,KW), W Almahmeed (Abu Dhabi,AE), H Amin (Bahrain,BH), A Al-Motarreb (Sana'a,YE), H Alfaleh (Riyadh,SA), P Panduranga (Muscat,OM), Z Mahfoud (Doha,QA), J Al Suwaidi (Doha,QA)

Authors:
C Abi Khalil1 , K Sulaiman2 , N Asaad3 , K Alhabib4 , A Alsheikh-Ali5 , M Jameesh3 , M Al-Jarallah6 , B Bulbanat6 , W Almahmeed7 , H Amin8 , A Al-Motarreb9 , H Alfaleh4 , P Panduranga2 , Z Mahfoud1 , J Al Suwaidi3 , 1Weill Cornell Medical College - Doha - Qatar , 2Royal Hospital - Muscat - Oman , 3Hamad Medical Corporation Heart Hospital - Doha - Qatar , 4King Fahad Cardiac Center - Riyadh - Saudi Arabia , 5College of Medicine Mohammed Bin Rashid University of Medicine and Health Sciences. - Dubai - United Arab Emirates , 6University of Kuwait - Kuwait City - Kuwait , 7Heart and Vascular Institute. Cleveland Clinic-Abu Dhabi, - Abu Dhabi - United Arab Emirates , 8Mohammed Bin Khalifa Cardiac Centre - Bahrain - Bahrain , 9Sana'a University - Sana'a - Yemen ,

On behalf: GULF-CARE group

Citation:

Background: The prognostic impact of beta-blockers (BB) in coronary artery disease (CAD) without heart failure (HF) is controversial, specially in the reperfusion-era. Moreover, it is not known whether patients with CAD and heart failure (HF) without left ventricular dysfunction might benefit from BB use

Purpose: We sought to assess the impact of BB on cardiovascular outcomes in patients with CAD and no LV dysfunction, hospitalized for acute HF. 

Methods: The Gulf-CARE (Gulf aCute heArt failuRe rEgistry) is a prospective multicenter cohort of acute HF in the GULF Middle East.We studied in-hospital cardiovascular events in patients hospitalized for acute HF, with a previous history of CAD and a LVEF =40%, in relation to BB on admission; and one-year outcome in relation to BB on discharge, in the GULF-CARE, a prospective multi-center cohort of acute HF.

Results: From a total of 5005 patients included in the GULF-CARE registry,824 had a previous history of CAD and a LVEF =40%. 303 patients on BB were propensity-matched to 303 patients without BB.  Mean age was 65 (11) and 53% were males.  BB did not reduce in-hospital mortality (OR= 0.82; 95%CI [0.35-1.94]), stroke, and cardiogenic shock.  On discharge, 306 patients on BB – including the ones newly diagnosed for myocardial infarction as a precipitating cause of HF- were propensity-scored matched with 306 patients without BB. Mortality (OR= 0.86; 95%CI [0.51-1.45], hospitalization for HF or PCI/CABG at 12 months were also were also not reduced by BB use at discharge. Further sensitivity analysis showed that BB treatment was not an independent predictor of in-hospital and 12-month mortality.

Conclusions: In this cohort of patients with acute HF, BB do not reduce in-hospital and one-year cardiovascular outcomes in patients with a previous history of CAD and a LVEF =40%.



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