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The effect of beta-blockers on mortality in patients with heart failure and atrial fibrillation: A meta-analysis of observational cohort and randomized controlled studies.
Cardiol J. 2018 Jul 16;:
Authors: Ma G, Fang Q, Wang F
Abstract
BACKGROUND: Beta-blockers (BB) are the cornerstone of therapy for heart failure (HF); however, the effects of these drugs on the prognosis of patients with concomitant atrial fibrillation (AF) remain controversial. The objective of this meta-analysis was to evaluate the efficacy of BB on mortality in HF coexisting with AF.
METHODS: A systematic search of PubMed, EMBASE and the Cochrane Library databases was conducted. Observational cohort studies (OCSs) and randomized controlled studies (RCTs) reporting outcomes of mortality or HF hospitalizations for patients with HF and AF, being assigned to BB treatment and non-BB group were included.
RESULTS: A total of 8 clinical studies (5 randomized controlled trials and 3 observational cohort studies) involving 34197 patients were included in the analysis. The pooled analysis demonstrated that BB treatment was associated with a 22% reduction in relative risk of all-cause mortality in patients with HF and AF (RR: 0.78; 95% CI 0.71-0.86; p < 0.00001; I² = 27%). The pooled analysis of 5 studies reporting the outcome of HF hospitalization (2774 patients) showed that BB therapy was not associated with a reduction of HF hospitalizations (RR: 0.94; 95% CI 0.79-1.11; p = 0.46; I² = 38%).
CONCLUSION: Our meta-analysis suggests the potential mortality benefit of BB in patients with HF and AF. We conclude that it is premature to deny patients with AF and HF BB therapy considering current evidence.
PMID: 30009373 [PubMed - as supplied by publisher]