Linked Life Data

19026308

Source:http://linkedlifedata.com/resource/pubmed/id/19026308

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
11
pubmed:dateCreated
2008-11-25
pubmed:abstractText
Heart failure (HF) guidelines recommend that beta blockers be titrated to achieve the target doses shown to be effective in major clinical trials, if tolerated. Little is known, however, regarding the doses of beta blockers used in patients with HF in routine clinical practice before, during, and after hospitalization for HF. The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) enrolled 5,791 patients admitted with HF in a registry with prespecified 60- to 90-day follow-up at 91 academic and community hospitals throughout the United States. Among 2,373 patients with systolic HF eligible for beta blockers at discharge, 1,350 (56.9%) were receiving beta-blocker therapy before admission and continued on therapy, and 632 (26.6%) were newly started. The mean total daily dose for beta blockers before hospital admission was <1/2 the recommended target dose (carvedilol 21.5 +/- 17.8 mg and metoprolol succinate 69.2 +/- 51.9 mg), with infrequent up- or down-titration during the HF hospitalization. More than 2/3 of patients had no change in their beta-blocker doses in the first 60 to 90 days after hospital discharge. At 60- to 90-day postdischarge follow-up, only 17.5% and 7.9% of patients were being treated with recommended target doses of carvedilol and metoprolol succinate, respectively. In conclusion, these data reveal that the doses of beta blockers applied in clinical practice are substantially less that the doses achieved in randomized clinical trials in HF and recommended in national guidelines. In the first 60 to 90 days after hospital discharge, little up-titration in beta-blocker dosing occurs. Further efforts are needed to help understand and overcome this beta-blocker titration gap.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Dec
pubmed:issn
1879-1913
pubmed:author
pubmed:issnType
Electronic
pubmed:day
1
pubmed:volume
102
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1524-9
pubmed:meshHeading
pubmed:year
2008
pubmed:articleTitle
Dosing of beta-blocker therapy before, during, and after hospitalization for heart failure (from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure).
pubmed:affiliation
Department of Medicine, UCLA Medical Center, Los Angeles, CA, USA. gfonarow@mednet.ucla.edu
pubmed:publicationType
Journal Article, Comparative Study, Research Support, Non-U.S. Gov't