Heart rate, heart rhythm and prognostic benefits of beta-blockers in heart failure: individual patient-data meta-analysis

Meta-analysis of individual-patient data from eleven double-blind randomized trials found that higher baseline heart rate was associated with greater all-cause mortality for those in sinus rhythm, but not for those in AF. Mortality was lower for patients in sinus rhythm assigned beta-blockers (HR 0....

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Bibliographic Details
Main Authors: Kotecha, D, Flather, M, Altman, D, Holmes, J, Rosano, G, Wikstrand, J, Packer, M, Coats, A, Manzano, L, Böhm, M, van Veldhuisen, D, Andersson, B, Wedel, H, von Lueder, T, Rigby, A, Hjalmarson, A, Kjekshus, J, Cleland, J
Format: Journal article
Published: Elsevier 2017
Description
Summary:Meta-analysis of individual-patient data from eleven double-blind randomized trials found that higher baseline heart rate was associated with greater all-cause mortality for those in sinus rhythm, but not for those in AF. Mortality was lower for patients in sinus rhythm assigned beta-blockers (HR 0.73, 95% CI 0.67-0.79; p<0.001), regardless of baseline heart rate. Beta-blockers had no effect on mortality in patients with AF (HR 0.96, 95% CI 0.81-1.12; p=0.58) at any heart rate. A lower achieved resting heart rate was associated with better prognosis only for patients in sinus rhythm (HR 1.16 per 10 beats/minute increase, 95% CI 1.11-1.22; p<0.0001).