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이달의 kcj Hot Article / 2019년 3월
Beta-Blockers in Patients with Heart Failure with Preserved Ejection Fraction: Results from The Korea Acute Heart Failure (KorAHF) Registry

저자

Sung-Hwan Kim, MD,1 Sung-Cheol Yun, PhD,2 Jin Joo Park, MD,3 Sang Eun Lee, MD,4 Eun-Seok Jeon, MD,5 Jae-Joong Kim, MD,4 Myeong-Chan Cho, MD,6 Shung Chull Chae, MD,7 Seok-Min Kang, MD,8 Dong-Ju Choi, MD,3 Byung-Su Yoo, MD,9 Kye Hun Kim, MD,10 Byung-Hee Oh, MD,11 Sang Hong Baek, MD,1 and on behalf of KorAHF investigator

소속

1Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. 2Department of Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. 3Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea. 4Division of Cardiology, Heart institute, Asan Medical Center, University of Ulsan, Seoul, Korea. 5Department of Internal Medicine, Sungkyunkwan University College of Medicine, Seoul, Korea. 6Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea. 7Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Korea. 8Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. 9Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. 10Department of Internal Medicine, Heart Research Center of Chonnam National University, Gwangju, Korea. 11Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.

Background and Objectives

Beta-blockers are indicated in patients with heart failure (HF) with reduced ejection fraction. However, their efficacy in patients with HF with preserved ejection fraction (HFpEF) is uncertain. We investigated the hypothesis that beta-blockers are associated with reduced adverse events in patients with HFpEF.

Methods

The Korea Acute Heart Failure (KorAHF) is a prospective observational multicentre cohort study. The 5,625 patients hospitalized for acute HF syndrome in 10 tertiary university hospitals across the country have been consecutively enrolled between March 2011 and February 2014. Of these patients, 2,152 patients with HFpEF (ejection fraction ≥40%) were investigated. The primary outcome was all-cause mortality according to beta-blocker use.

Results

During a median follow-up duration of 807 days, 702 patients died. In Cox proportional hazards model beta-blocker use was associated with a 14% reduced all-cause death (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.75–0.98), but not with reduce rehospitalization (HR, 1.03; 95% CI, 0.85–1.27). In the propensity-score matched population, beta-blockers were also associated with reduced all-cause death (HR, 0.80; 95% CI, 0.69–0.94) but not with reduced rehospitalization (HR, 1.08; 95% CI, 0.87–1.33).

Conclusions

In Korean patients with HFpEF, use of beta-blockers is associated with reduced all-cause death but not with reduced rehospitalization.


Keywords: Adrenergic beta-antagonist; Heart failure; Diastole

원문보기 : https://www.e-kcj.org/DOIx.php?id=10.4070/kcj.2018.0259

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