Heart failure & cardiomyopathiesMeta-analysis
Beta-Blocker Discontinuation in Acute Heart Failure
- systematic review
- meta-analysis of observational studies
- generic inverse-variance random-effects models
- randomized and observational studies
Authors' conclusion
Available evidence on beta-blocker discontinuation in ADHF is of very low certainty and findings of possible harm may reflect confounding by indication and failure to restart therapy rather than causal harm. Further high-quality randomized controlled trials and nonrandomized studies may resolve uncertainty.
Study context
- Population
- Patients hospitalized for acute decompensated heart failure (ADHF)Thirteen studies · 1 randomized trial 147 · 12 cohort studies 14,654
- Comparison
- beta-blocker discontinuation vs continuation
Pooled result
In-hospital mortality
Pooled odds ratio
5.20
95% CI 0.24–113.06
beta-blocker discontinuation vs continuation
pooled OR 5.20 (95% CI 0.24–113.06)
As reported in the abstract
Further pooled results
| Outcome | Estimate | |
|---|---|---|
| Mortality up to 3 months (short-term discontinuation) · I2 = 0%, 2 studies | pooled HR 2.30 (95% CI 1.23–4.29) | |
| Long-term mortality · One study, adjusted estimate | HR 1.55 (95% CI 0.69–3.51) | |
| In-hospital mortality (randomized trial) · single randomized controlled trial | risk ratio 1.77 (95% CI 0.16–19.1) | |
| Short-term mortality (randomized trial) · single randomized controlled trial | risk ratio 0.88 (95% CI 0.30–2.62) | |
| 0.050.21520Ratio (log scale) |
Rehospitalization
- Findings inconsistent and did not favor either approach
Certainty of evidence
- All findings were low or very low certainty
Original publication
Beta-Blocker Discontinuation in Acute Heart Failure. JACC Adv. Published 18 June 2026. doi:10.1016/j.jacadv.2026.102929
Summarised from the published abstract; every number is checked against it