β-blockers and risk of all-cause mortality in patients with chronic heart failure and atrial fibrillation—a meta-analysis
Abstract Background Effects of β-blockers on outcomes in patients with chronic heart failure (CHF) and atrial fibrillation (AF) is still in controversy. Methods Searching was conducted by using keywords “atrial fibrillation”, and “heart failure” in PubMed, MEDLINE and Embase databases before Novembe...
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| Format: | Article |
| Language: | English |
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BMC
2019-06-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12872-019-1079-2 |
| _version_ | 1818873566934859776 |
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| author | Tianyu Xu Yuli Huang Haobin Zhou Yujia Bai Xingfu Huang Yunzhao Hu Dingli Xu Yuhui Zhang Jian Zhang |
| author_facet | Tianyu Xu Yuli Huang Haobin Zhou Yujia Bai Xingfu Huang Yunzhao Hu Dingli Xu Yuhui Zhang Jian Zhang |
| author_sort | Tianyu Xu |
| collection | DOAJ |
| description | Abstract Background Effects of β-blockers on outcomes in patients with chronic heart failure (CHF) and atrial fibrillation (AF) is still in controversy. Methods Searching was conducted by using keywords “atrial fibrillation”, and “heart failure” in PubMed, MEDLINE and Embase databases before November 30, 2017. Prospective studies [i.e. randomized control trials (RCTs), post-hoc analysis of RCTs, prospective cohort studies and registry studies] that studied the effect of β-blockers and all-cause mortality in patients with CHF and AF were included. The analysis was stratified by study design. Results We identified 12 studies, including 6 post-hoc analysis of RCTs and 6 observational studies (including prospective registry studies and prospective cohort studies), which enrolled 38,133 patients with CHF and AF. Overall, β-blockers treatment was associated with significant decrease in all-cause mortality [Risk Ratio (RR) =0.73; 95% Confidence Interval (CI) 0.65–0.82, P < 0.001]. When stratified by study design, β-blockers treatment was associated with 34% reduction in patients with CHF and AF in observational study (RR = 0.66; 95% CI 0.58–0.76, P < 0. 001), but not in post-hoc analysis of RCT (RR = 0.87; 95% CI 0.74–1.02, P = 0.09). Conclusions β-blockers treatment was associated with significantly decrease the risk of all-cause mortality in patients with AF-CHF and it was only seen in observational study group, but not in subgroup analysis of RCT group. Further large RCTs are required to verify the effect of β-blockers treatment on patients with CHF and AF. The main limitation of this study is the lack of individual data on patients in each study. |
| first_indexed | 2024-12-19T12:56:45Z |
| format | Article |
| id | doaj.art-542b1b3e0ce84963b77040c99b143a74 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-19T12:56:45Z |
| publishDate | 2019-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-542b1b3e0ce84963b77040c99b143a742022-12-21T20:20:22ZengBMCBMC Cardiovascular Disorders1471-22612019-06-0119111010.1186/s12872-019-1079-2β-blockers and risk of all-cause mortality in patients with chronic heart failure and atrial fibrillation—a meta-analysisTianyu Xu0Yuli Huang1Haobin Zhou2Yujia Bai3Xingfu Huang4Yunzhao Hu5Dingli Xu6Yuhui Zhang7Jian Zhang8State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiology, Shunde Hospital, Southern Medical UniversityState Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical UniversityState Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical UniversityState Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical UniversityDepartment of Cardiology, Shunde Hospital, Southern Medical UniversityState Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical UniversityState Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeState Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Background Effects of β-blockers on outcomes in patients with chronic heart failure (CHF) and atrial fibrillation (AF) is still in controversy. Methods Searching was conducted by using keywords “atrial fibrillation”, and “heart failure” in PubMed, MEDLINE and Embase databases before November 30, 2017. Prospective studies [i.e. randomized control trials (RCTs), post-hoc analysis of RCTs, prospective cohort studies and registry studies] that studied the effect of β-blockers and all-cause mortality in patients with CHF and AF were included. The analysis was stratified by study design. Results We identified 12 studies, including 6 post-hoc analysis of RCTs and 6 observational studies (including prospective registry studies and prospective cohort studies), which enrolled 38,133 patients with CHF and AF. Overall, β-blockers treatment was associated with significant decrease in all-cause mortality [Risk Ratio (RR) =0.73; 95% Confidence Interval (CI) 0.65–0.82, P < 0.001]. When stratified by study design, β-blockers treatment was associated with 34% reduction in patients with CHF and AF in observational study (RR = 0.66; 95% CI 0.58–0.76, P < 0. 001), but not in post-hoc analysis of RCT (RR = 0.87; 95% CI 0.74–1.02, P = 0.09). Conclusions β-blockers treatment was associated with significantly decrease the risk of all-cause mortality in patients with AF-CHF and it was only seen in observational study group, but not in subgroup analysis of RCT group. Further large RCTs are required to verify the effect of β-blockers treatment on patients with CHF and AF. The main limitation of this study is the lack of individual data on patients in each study.http://link.springer.com/article/10.1186/s12872-019-1079-2Heart failureAtrial fibrillationBeta blockersAll-cause mortality |
| spellingShingle | Tianyu Xu Yuli Huang Haobin Zhou Yujia Bai Xingfu Huang Yunzhao Hu Dingli Xu Yuhui Zhang Jian Zhang β-blockers and risk of all-cause mortality in patients with chronic heart failure and atrial fibrillation—a meta-analysis BMC Cardiovascular Disorders Heart failure Atrial fibrillation Beta blockers All-cause mortality |
| title | β-blockers and risk of all-cause mortality in patients with chronic heart failure and atrial fibrillation—a meta-analysis |
| title_full | β-blockers and risk of all-cause mortality in patients with chronic heart failure and atrial fibrillation—a meta-analysis |
| title_fullStr | β-blockers and risk of all-cause mortality in patients with chronic heart failure and atrial fibrillation—a meta-analysis |
| title_full_unstemmed | β-blockers and risk of all-cause mortality in patients with chronic heart failure and atrial fibrillation—a meta-analysis |
| title_short | β-blockers and risk of all-cause mortality in patients with chronic heart failure and atrial fibrillation—a meta-analysis |
| title_sort | β blockers and risk of all cause mortality in patients with chronic heart failure and atrial fibrillation a meta analysis |
| topic | Heart failure Atrial fibrillation Beta blockers All-cause mortality |
| url | http://link.springer.com/article/10.1186/s12872-019-1079-2 |
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