Heart failure & cardiomyopathies
Prognostic Impact of Beta-Blocker Use by N-Terminal Pro-Brain Natriuretic Peptide Level in Acute Heart Failure Patients
Authors' conclusion
In patients with acute HF, BB use is associated with reduced all-cause mortality in those with HFrEF but not in those with HFpEF. HFrEF patients with NT-proBNP levels of <4800 pg/mL treated with BB have a higher survival rate than those not treated with BB. However, this benefit is not seen in HFrEF patients with NT-proBNP levels of ≥4800 pg/mL or in all HFpEF patients, regardless of the NT-proBNP level.
Study context
- Population
- Patients admitted for acute heart failure (HF) at Ulsan University Hospital, January 2012–December 2017
- Participants
- 472 patients
- Exposure
- Beta-blocker (BB) vs no BB at discharge, by HF type and N-terminal pro-brain natriuretic peptide (NT-proBNP) level
- BBn = 216
- No BBn = 256reference
- Outcome
- All-cause mortality
- Follow-up
- Median 44 months
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Reduced all-cause mortality with BB in HFrEF (EF ≤ 40%) but not in HF with preserved ejection fraction (HFpEF) (EF > 40%) (Kaplan-Meier)
- BB use an independent predictor of all-cause mortality in HFrEF (multivariate Cox), with E/E' and NT-proBNP
- HFpEF: survival with BB did not differ according to NT-proBNP levels
- BB vs No BB: log-rank P < 0.001
Observational data: associations, not effects.
Further findings
All-cause deaths (overall) · median follow-up 44 months
- Patients who died
- 224 (47.5%)
Predictors of all-cause mortality in HFpEF
- Haemoglobin and NT-proBNP independent predictors in HFpEF
Comorbidities with NT-proBNP ≥4800 pg/mL
- Both HFrEF and HFpEF: lower BMI and haemoglobin, higher creatinine, NT-proBNP and E/E'
Original publication
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