Beta-Blockers for Heart Failure With Atrial Fibrillation
Beta-blockers were associated with lower all-cause mortality in HFrEF and afib, but not hospitalizations.
HealthDay News – Beta-blockers are associated with significantly reduced mortality, but not hospitalizations, in patients with heart failure with reduced ejection fraction (HFrEF) and atrial fibrillation (AF), according to a study published online in JACC: Heart Failure.
Julia Cadrin-Tourigny, MD, from the Université de Montréal, and colleagues examined the impact of beta-blockers on mortality and hospitalizations in patients with AF and HFrEF in the AF-CHF trial. Among 1376 participants randomized in the trial, the authors propensity-matched those without beta-blockers at baseline to a maximum of 2 exposed patients.
The researchers found that beta-blockers correlated with significantly lower all-cause mortality (hazard ratio [HR]: 0.721; 95% CI, 0.549-0.945; P =.0180) but not hospitalizations (HR: 0.886; 95% CI, 0.715-1.100; P =.2232) during a median follow-up of 37 months. In sensitivity analyses that modeled beta-blockers as a time-dependent variable the results were similar (HR for all-cause mortality: 0.668; 95% CI, 0.511-0.874; P =.0032; HR for hospitalizations: 0.814; 95% CI, 0.653-1.014; P =.0658). With respect to mortality and hospitalizations, there were no significant interactions for beta-blockers and pattern or burden of AF.
"These results support current evidence-based recommendations for beta-blockers in patients with HFrEF, whether or not they have associated AF," the authors wrote.
Cadrin-Tourigny J, Shohoudi A, Roy D, et al. Decreased mortality with beta-blockers in patients with heart failure and coexisting atrial fibrillation. An AF-CHF substudy [Published online January 11, 2017]. JACC Heart Fail. doi:10.1016/j.jchf.2016.10.015