Heart failure & cardiomyopathies
Effect of Beta-Blockade on Mortality in Patients with Cardiac Amyloidosis: A Systematic Review and Meta-Analysis
Pooled result · Mortality with beta-blocker use at any time pointResult — go to the resultRelative risk 0.48 95% CI 0.29–0.80Authors' conclusion
Treatment with beta-blockers may be associated with a survival benefit in patients with CA, but these findings are subject to selection and survivor biases.
Study context
- Population
- Patients with cardiac amyloidosis (ATTR-CM, amyloid cardiomyopathy (AL-CM)); age 74.8 ± 5.5 years, 76% male
- Participants
- 4,215 patients13 studies
- Comparison
- Beta-blocker therapy vs no beta-blocker
- Outcome
- All-cause mortality
- Follow-up
- Median ranging from 13 to 36 months
Methodological detailsrandom effects, No information on staging of cardiac amyloidosis (CA) (limitation)
- Random effects
- No information on staging of CA (limitation)
Pooled result
As reported in the abstract
Mortality with beta-blocker use at any time point
Relative risk
0.48
95% CI 0.29–0.80
P = 0.005
Beta-blockersvs No beta-blockers
RR 0.48 (95% CI 0.29–0.80); P = 0.005
Further pooled results
| Outcome | Estimate | P value | |
|---|---|---|---|
| Mortality, ATTR-CM-only studies (subgroup)I2 = 88%; three studies | RR 0.65 (95% CI 0.29–1.47) | P = 0.30 | |
| Mortality, studies with both ATTR-CM and AL (subgroup)I2 = 4%; three studies | OR 0.43 (95% CI 0.29–0.63) | P < 0.001 | |
| Survival, AL-CM-only study (subgroup, n = 53)53% tolerated beta-blockers | RR 0.26 (95% CI 0.08–0.79) | P = 0.02 | |
| 0.050.21520Ratio (log scale) |
All-cause mortality, overall cohort · median follow-up 13 to 36 months
- All-cause mortality
- 33% (range: 13-51%)
- Received beta-blockers
- 52%
- Beta-blocker withdrawal
- 28%
Original publication
Effect of Beta-Blockade on Mortality in Patients with Cardiac Amyloidosis: A Systematic Review and Meta-Analysis. ESC Heart Fail. Published 23 July 2024. doi:10.
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