• 作者：Xavier Garcia-Moll^a ; ^{xgarcia-moll@santpau.cat} ; Lorenzo Fá ; cila^b ; Pedro Conthe^c ; Antonio Zapata^d ; Remei Artigas^d ; Vicente Bertomeu^e ; José ; Ramó ; n Gonzá ; lez-Juanatey^f ; en nombre de los investigadores del estudio CARACTER-BETA^&loz ;
• 关键词：BB ; bloqueadores beta ; EPOC ; enfermedad pulmonar obstructiva cró ; nica ; FA ; fibrilació ; n auricular ; ICC ; insuficiencia cardiaca cró ; nica ; IECA ; inhibidores de la enzima de conversió ; n de la angiotensina
• 刊名：Revista Espa帽ola de Cardiolog铆a
• 出版年：2011
• 期刊代码：pca308_03008932
• 类别：med
• 出版时间：October 2011
• 卷：64
• 期：10
• 页码：883-890
• 文件大小：311 K

Introduction and objectives

Beta-blocker treatment has a class I indication, level of evidence A, in guidelines for the treatment of heart failure, ischemic heart disease, and atrial fibrillation. However, beta-blocker use continues to be less than optimal. In this study, beta blocker use in Spain is analyzed in patients with heart failure, ischemic heart disease, and atrial fibrillation.

Methods

Observational, epidemiologic, cross-sectional, multicenter study including 1608 patients with heart failure, ischemic heart disease, and/or atrial fibrillation, recruited in 150 healthcare centers by cardiologists and internal medicine specialists.

Results

Cardiologists enrolled 78.6%patients and internal medicine specialists 21.4%; 25.8%were recruited at hospital discharge and 74.2%at outpatient centers. Men accounted for 77%of the sample, and age was 68 (12) years. Of the total, 73%had ischemic heart disease, 42%heart failure, and 36%atrial fibrillation (multiresponse variable). Beta blockers were given to 82.8%of those consulting in cardiology compared to 71.6%of those treated in internal medicine (P<.0001). By pathology, the prescription rate was 85.1%of patients with ischemic heart disease, 77.0%of those with heart failure, and 72.4%of those with atrial fibrillation. Cardiology prescribed significantly more beta blockers for ischemic heart disease and heart failure than did internal medicine. Multivariate analysis showed that beta blocker use increased when the patient had ischemic heart disease, was treated by a cardiologist, and had dyslipidemia, stroke, and/or left ventricular hypertrophy. beta blocker use decreased with age and with a history of bronchospasm, asthma, bradycardia, chronic obstructive pulmonary disease, and/or intermittent claudication.

Conclusions

There is still room for improvement in beta blocker prescription in Spain for patients with ischemic heart disease, heart failure, and/or atrial fibrillation.

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