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Differences in the Effects of Beta-Blockers Depending on Heart Rate at Discharge in Patients With Heart Failure With

Young In Kim1, Min-Soo Ahn1, Byung-Su Yoo1

  • 1Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.

International Journal of Heart Failure
|July 31, 2024
PubMed

Insights

Beta-blockers may reduce heart failure rehospitalization in patients with atrial fibrillation and preserved ejection fraction if their heart rate is high at discharge. This finding suggests tailored treatment approaches for heart failure with preserved ejection fraction patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Beta-blockers (BBs) are standard for heart failure (HF) prognosis, primarily via heart rate (HR) reduction.
  • However, their benefit in HF with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) is unclear, as HR lacks prognostic significance in AF.

Purpose of the Study:

  • To investigate the prognostic role of BBs in HFpEF patients with AF, stratified by discharge HR.

Main Methods:

  • A cohort of 687 patients with HFpEF and AF was analyzed from the Korean Acute Heart Failure Registry.
  • Patients were categorized based on discharge HR (75 bpm threshold) and BB treatment status.

Main Results:

  • In patients with high discharge HR (>75 bpm), BB treatment was linked to an 82% reduction in 60-day HF rehospitalization.
  • BBs did not significantly impact mortality in either the low or high HR groups.
  • In the low HR group, BBs showed no significant effect on rehospitalization or mortality.

Conclusions:

  • For HFpEF patients with AF and a discharge HR above 75 bpm, BBs may reduce short-term rehospitalization rates.
  • Discharge HR may be a critical factor in determining BB efficacy for HFpEF patients with AF.
Abstract

Keywords:
Atrial fibrillationHeart failureHeart rate

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