Source:http://linkedlifedata.com/resource/pubmed/id/19064029
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
12
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pubmed:dateCreated |
2008-12-9
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pubmed:abstractText |
Beta blockers are underprescribed to elderly patients with systolic heart failure (HF). We studied whether the prescription of a beta blocker is associated with a survival benefit in a nonselected population of patients >70 years of age hospitalized with acute HF and systolic dysfunction. We studied 272 consecutive patients >70 years (median 77.0, interquartile range 73.4 to 81.1) hospitalized with acute HF (left ventricular ejection fraction 34 +/- 8%) during a 2-year period. At discharge, beta-blocker therapy was prescribed in 139 patients (51.1%). A propensity score for the likelihood of receiving beta-blocker therapy was developed and showed a good performance (c-statistic = 0.825 and Hosmer-Lemeshow p = 0.820). After discharge, 120 patients (44.1%) died during the follow-up (median 31 months, interquartile range 12 to 46). Cox regression analysis showed a lower risk of death associated with beta-blocker prescription (p <0.001, hazard ratio [HR] 0.450, 95% confidence interval [CI] 0.310 to 0.655), which persisted after risk adjusting for the propensity score (HR 0.521, 95% CI 0.325 to 0.836, p = 0.007). In a propensity-matched cohort of 130 patients, there was a significantly lower mortality in patients receiving beta blockers (log rank 0.009, HR 0.415, 95% CI 0.234 to 0.734, p = 0.003). Risk reduction associated with beta blockade was observed with both high doses (HR 0.472, 95% CI 0.300 to 0.742, p = 0.001) and low doses (HR 0.425, 95% CI 0.254 to 0.711, p = 0.001). In conclusion, beta-blocker prescription at discharge in a nonselected population >70 years of age hospitalized with systolic HF is associated with a significantly lower risk of death even at low doses. This benefit remains consistent after adjustment for potential confounders.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
AIM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:month |
Dec
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pubmed:issn |
1879-1913
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pubmed:author | |
pubmed:issnType |
Electronic
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pubmed:day |
15
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pubmed:volume |
102
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
1711-7
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pubmed:dateRevised |
2010-11-18
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pubmed:meshHeading |
pubmed-meshheading:19064029-Acute Disease,
pubmed-meshheading:19064029-Adrenergic beta-Antagonists,
pubmed-meshheading:19064029-Aged,
pubmed-meshheading:19064029-Aged, 80 and over,
pubmed-meshheading:19064029-Dose-Response Relationship, Drug,
pubmed-meshheading:19064029-Female,
pubmed-meshheading:19064029-Heart Failure, Systolic,
pubmed-meshheading:19064029-Hospitalization,
pubmed-meshheading:19064029-Humans,
pubmed-meshheading:19064029-Kaplan-Meier Estimate,
pubmed-meshheading:19064029-Male,
pubmed-meshheading:19064029-Multivariate Analysis,
pubmed-meshheading:19064029-Proportional Hazards Models,
pubmed-meshheading:19064029-Risk Factors,
pubmed-meshheading:19064029-Selection Bias,
pubmed-meshheading:19064029-Survival Rate,
pubmed-meshheading:19064029-Ventricular Dysfunction, Left
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pubmed:year |
2008
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pubmed:articleTitle |
Comparison of late mortality in hospitalized patients >70 years of age with systolic heart failure receiving beta blockers versus those not receiving beta blockers.
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pubmed:affiliation |
Cardiology Department, University Hospital Virgen de la Arrixaca, University of Murcia, Spain. dapascual@servicam.com
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pubmed:publicationType |
Journal Article,
Comparative Study,
Research Support, Non-U.S. Gov't
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