- 作者：Andr茅s Gonz谩lez-Garc铆a ; Manuel Montero P茅rez-Barquero ; Francesc Formiga ; Jos茅 R. Gonz谩lez-Juanatey ; M. Angustias Quesada ; Francisco Epelde ; Roberto Oropesa ; Jes煤s D铆ez-Manglano ; Jos茅 M. Cerqueiro ; Luis Manzano ; en representaci贸n de los investigadores del registro RICA
- 关键词：BB ; bloqueadores beta ; FEVI ; fracció ; n de eyecció ; n del ventrí ; culo izquierdo ; IC ; insuficiencia cardiaca
- 刊名：Revista Espa?ola de Cardiología
- 出版年：March, 2014
- 年：2014
- 卷：67
- 期：3
- 页码：196-202
- 全文大小：258 K
Introduction and objectives
Underuse of beta-blockers has been reported in elderly patients with heart failure. The aim of this study was to evaluate the current prescription of beta-blockers in the internal medicine setting, and its association with morbidity and mortality in heart failure patients.
Methods
The information analyzed was obtained from a prospective cohort of patients hospitalized for heart failure (RICA registry database, patients included from March 2008 to September 2011) with at least one year of follow-up. We investigated the percentage of patients prescribed beta-blockers at hospital discharge, and at 3 and 12 months, and the relationship of beta-blocker use with mortality and readmissions for heart failure. Patients with significant valve disease were excluded.
Results
A total of 515 patients were analyzed (53.5% women), with a mean age of 77.1 (8.7) years. Beta-blockers were prescribed in 62.1% of patients at discharge. A similar percentage was found at 3 months (65.6%) and 12 months (67.9%) after discharge. All-cause mortality and the composite of all-cause mortality and readmission for heart failure were significantly lower in patients treated with beta-blockers (hazard ratio=0.59, 95% confidence interval, 0.41-0.84 vs hazard ratio=0.64, 95% confidence interval, 0.49-0.83). This decrease in mortality was maintained after adjusting by age, sex, ejection fraction, functional class, comorbidities, and concomitant treatment.
Conclusions
The findings of this study indicate that beta-blocker use is increasing in heart failure patients (mainly elderly) treated in the internal medicine setting, and suggest that the use of these drugs is associated with a reduction in clinical events.
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