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Beta-blocker withdrawal linked to negative outcomes in patients with acute decompensated HF
Patients with acute decompensated HF who discontinue beta-blockers may have an increased risk for mortality and rehospitalization, according to results of a new systematic review and meta-analysis.
Researchers identified studies published from January 2000 to January 2015 that compared ongoing beta-blocker treatment with beta-blocker discontinuation and reported in-hospital and short-term outcomes in patients with acute decompensated HF. They reviewed five observational studies and one randomized controlled trial that met the criteria. In all, 2,704 participants remained on continuous beta-blocker treatment and 439 discontinued beta-blockers.
Two studies demonstrated a significant risk for in-hospital death associated with beta-blocker discontinuation (RR = 3.72; 95% CI, 1.51-9.14). Four studies showed a link between beta-blocker discontinuation and significantly increased short-term mortality (RR = 1.61; 95% CI, 1.04-2.79). In four studies, beta-blocker withdrawal was also associated with significantly increased short-term rehospitalization and/or death (RR = 1.59; 95% CI, 1.03-2.45).
“Continuation of beta-blockers in acute decompensated HF was associated with significant reductions in risk of in-hospital mortality, short-term mortality and short-term combined rehospitalization or death,” the researchers concluded. “These data suggest that beta-blockers should be continued in acute decompensated HF if the clinical situation allows in an attempt to reduce adverse outcomes.” – by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures.