Heart failure & cardiomyopathies
Beta-Blocker Use and Heart Failure Outcomes in Mildly Reduced and Preserved Ejection Fraction
Authors' conclusion
In a large, real-world, propensity score-adjusted cohort of older outpatients with HF and EF ≥40%, beta-blocker use was associated with a higher risk of HF hospitalization as EF increased, with potential benefit in patients with HFmrEF and potential risk in patients with higher EF (particularly >60%).
Study context
- Population
- Outpatients ≥65 years with heart failure with mildly reduced ejection fraction (HFmrEF) or heart failure with preserved ejection fraction (HFpEF) (ejection fraction (EF) ≥40%), US PINNACLE Registry, 2013–2017HFmrEF 75,674
- Participants
- 435,897 outpatients
- Exposure
- Beta-blocker use vs no beta-blocker use
- Beta-blockern = 289,377
- Outcome
- HF hospitalization, death, and composite of HF hospitalization/death
Methodological detailspropensity-score adjusted, registry-based
- Propensity-score adjusted
- Registry-based
Main finding
As reported in the abstract
HF hospitalization, death, composite; interaction EF × beta-blocker use
- Significant EF × beta-blocker interactions for heart failure (HF) hospitalization, death and composite, with higher risk with beta-blocker use as EF increased
- P < 0.001 for all
Observational data: associations, not effects.
Further findings
Beta-blocker use at first encounter, HFmrEF vs HFpEF
P < 0.001
- Beta-blocker use at first encounter, HFmrEF vs HFpEF: overall 289,377 (66.4%) using a beta-blocker
Original publication
Beta-Blocker Use and Heart Failure Outcomes in Mildly Reduced and Preserved Ejection Fraction. JACC Heart Fail. Published 3 May 2023. doi:10.
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