Beta-blocker therapy in heart failure with preserved ejection fraction (B-HFpEF): a systematic review and meta-analysis

<h3>Introduction</h3><p dir="ltr">While beta-blockers are considered the cornerstone of treatment for heart failure with reduced ejection fraction, the same may not apply to patients with heart failure with preserved ejection fraction (HFpEF). To date, the benefit of beta...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Dr. Rasha Kaddoura (17823428) (author)
مؤلفون آخرون: Vichithranie Madurasinghe (3438182) (author), Ammar Chapra (14777698) (author), Dina Abushanab (10696501) (author), Associate Prof. Daoud Al-Badriyeh (17823431) (author), Ashfaq Patel (16855122) (author)
منشور في: 2024
الموضوعات:
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author Dr. Rasha Kaddoura (17823428)
author2 Vichithranie Madurasinghe (3438182)
Ammar Chapra (14777698)
Dina Abushanab (10696501)
Associate Prof. Daoud Al-Badriyeh (17823431)
Ashfaq Patel (16855122)
author2_role author
author
author
author
author
author_facet Dr. Rasha Kaddoura (17823428)
Vichithranie Madurasinghe (3438182)
Ammar Chapra (14777698)
Dina Abushanab (10696501)
Associate Prof. Daoud Al-Badriyeh (17823431)
Ashfaq Patel (16855122)
author_role author
dc.creator.none.fl_str_mv Dr. Rasha Kaddoura (17823428)
Vichithranie Madurasinghe (3438182)
Ammar Chapra (14777698)
Dina Abushanab (10696501)
Associate Prof. Daoud Al-Badriyeh (17823431)
Ashfaq Patel (16855122)
dc.date.none.fl_str_mv 2024-03-01T03:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.cpcardiol.2024.102376
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Beta-blocker_therapy_in_heart_failure_with_preserved_ejection_fraction_B-HFpEF_a_systematic_review_and_meta-analysis/25038278
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Cardiovascular medicine and haematology
Clinical sciences
Pharmacology and pharmaceutical sciences
Mathematical sciences
Statistics
Adrenergic beta-antagonists
Bisoprolol
Carvedilol
Diastolic dysfunction
HFpEF
Metoprolol
Nebivolo
dc.title.none.fl_str_mv Beta-blocker therapy in heart failure with preserved ejection fraction (B-HFpEF): a systematic review and meta-analysis
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Introduction</h3><p dir="ltr">While beta-blockers are considered the cornerstone of treatment for heart failure with reduced ejection fraction, the same may not apply to patients with heart failure with preserved ejection fraction (HFpEF). To date, the benefit of beta-blockers remains uncertain, and there is no current consensus on their effectiveness. This study sought to evaluate the efficacy of beta-blockers on mortality and rehospitalization among patients with HFpEF.</p><h3>Methods</h3><p dir="ltr">A systematic review and meta-analysis of randomized or observational cohort studies examined the efficacy of beta-blocker therapy in comparison with placebo, control, or standard medical care in patients with HFpEF, defined as left ventricular ejection fraction ≥50 %. The main endpoints were mortality (i.e., all-cause and cardiovascular), rehospitalization (i.e., all-cause and for heart failure) and a composite of the two.</p><h3>Results</h3><p dir="ltr">Out of the 13,189 records initially identified, 16 full-text records met the inclusion criteria and were analyzed recruiting a total of 27,188 patients. The mean age range was 62–84 years old, predominantly female, with HFpEF in which 63.4 % of patients received a beta-blocker and 36.6 % did not. The pooled analysis of included cohort studies, of variable follow-up durations, showed a significant reduction in all-cause mortality by 19 % (odds ratio (OR) 0.81; 95 % confidence interval (CI): 0.65–0.99, p = 0.044) whereas rehospitalization for heart failure (OR 1.13; 95 % CI: 0.91–1.41, p = 0.27) or its composite with all-cause mortality (OR 1.01; 95 % CI: 0.78–1.32, p = 0.92) were similar between the beta-blocker and control groups.</p><h3>Conclusion</h3><p dir="ltr">This meta-analysis showed that beta-blocker therapy has the potential to reduce all-cause mortality in patients with HFpEF based on observational studies. Nevertheless, it did not affec rehospitalization for heart failure or its composite with all-cause mortality. Large scale randomized trials are needed to clarify this uncertainty.</p><h2>Other Information</h2><p dir="ltr">Published in: Current Problems in Cardiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.cpcardiol.2024.102376" target="_blank">https://dx.doi.org/10.1016/j.cpcardiol.2024.102376</a></p>
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oai_identifier_str oai:figshare.com:article/25038278
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spelling Beta-blocker therapy in heart failure with preserved ejection fraction (B-HFpEF): a systematic review and meta-analysisDr. Rasha Kaddoura (17823428)Vichithranie Madurasinghe (3438182)Ammar Chapra (14777698)Dina Abushanab (10696501)Associate Prof. Daoud Al-Badriyeh (17823431)Ashfaq Patel (16855122)Biomedical and clinical sciencesCardiovascular medicine and haematologyClinical sciencesPharmacology and pharmaceutical sciencesMathematical sciencesStatisticsAdrenergic beta-antagonistsBisoprololCarvedilolDiastolic dysfunctionHFpEFMetoprololNebivolo<h3>Introduction</h3><p dir="ltr">While beta-blockers are considered the cornerstone of treatment for heart failure with reduced ejection fraction, the same may not apply to patients with heart failure with preserved ejection fraction (HFpEF). To date, the benefit of beta-blockers remains uncertain, and there is no current consensus on their effectiveness. This study sought to evaluate the efficacy of beta-blockers on mortality and rehospitalization among patients with HFpEF.</p><h3>Methods</h3><p dir="ltr">A systematic review and meta-analysis of randomized or observational cohort studies examined the efficacy of beta-blocker therapy in comparison with placebo, control, or standard medical care in patients with HFpEF, defined as left ventricular ejection fraction ≥50 %. The main endpoints were mortality (i.e., all-cause and cardiovascular), rehospitalization (i.e., all-cause and for heart failure) and a composite of the two.</p><h3>Results</h3><p dir="ltr">Out of the 13,189 records initially identified, 16 full-text records met the inclusion criteria and were analyzed recruiting a total of 27,188 patients. The mean age range was 62–84 years old, predominantly female, with HFpEF in which 63.4 % of patients received a beta-blocker and 36.6 % did not. The pooled analysis of included cohort studies, of variable follow-up durations, showed a significant reduction in all-cause mortality by 19 % (odds ratio (OR) 0.81; 95 % confidence interval (CI): 0.65–0.99, p = 0.044) whereas rehospitalization for heart failure (OR 1.13; 95 % CI: 0.91–1.41, p = 0.27) or its composite with all-cause mortality (OR 1.01; 95 % CI: 0.78–1.32, p = 0.92) were similar between the beta-blocker and control groups.</p><h3>Conclusion</h3><p dir="ltr">This meta-analysis showed that beta-blocker therapy has the potential to reduce all-cause mortality in patients with HFpEF based on observational studies. Nevertheless, it did not affec rehospitalization for heart failure or its composite with all-cause mortality. Large scale randomized trials are needed to clarify this uncertainty.</p><h2>Other Information</h2><p dir="ltr">Published in: Current Problems in Cardiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.cpcardiol.2024.102376" target="_blank">https://dx.doi.org/10.1016/j.cpcardiol.2024.102376</a></p>2024-03-01T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.cpcardiol.2024.102376https://figshare.com/articles/journal_contribution/Beta-blocker_therapy_in_heart_failure_with_preserved_ejection_fraction_B-HFpEF_a_systematic_review_and_meta-analysis/25038278CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/250382782024-03-01T03:00:00Z
spellingShingle Beta-blocker therapy in heart failure with preserved ejection fraction (B-HFpEF): a systematic review and meta-analysis
Dr. Rasha Kaddoura (17823428)
Biomedical and clinical sciences
Cardiovascular medicine and haematology
Clinical sciences
Pharmacology and pharmaceutical sciences
Mathematical sciences
Statistics
Adrenergic beta-antagonists
Bisoprolol
Carvedilol
Diastolic dysfunction
HFpEF
Metoprolol
Nebivolo
status_str publishedVersion
title Beta-blocker therapy in heart failure with preserved ejection fraction (B-HFpEF): a systematic review and meta-analysis
title_full Beta-blocker therapy in heart failure with preserved ejection fraction (B-HFpEF): a systematic review and meta-analysis
title_fullStr Beta-blocker therapy in heart failure with preserved ejection fraction (B-HFpEF): a systematic review and meta-analysis
title_full_unstemmed Beta-blocker therapy in heart failure with preserved ejection fraction (B-HFpEF): a systematic review and meta-analysis
title_short Beta-blocker therapy in heart failure with preserved ejection fraction (B-HFpEF): a systematic review and meta-analysis
title_sort Beta-blocker therapy in heart failure with preserved ejection fraction (B-HFpEF): a systematic review and meta-analysis
topic Biomedical and clinical sciences
Cardiovascular medicine and haematology
Clinical sciences
Pharmacology and pharmaceutical sciences
Mathematical sciences
Statistics
Adrenergic beta-antagonists
Bisoprolol
Carvedilol
Diastolic dysfunction
HFpEF
Metoprolol
Nebivolo