Key result
Beta-blocker use is linked to a ~182% higher AF risk in HF patients.
Why the study?
Although beta-receptor blockers are used to treat HF, their role in the occurrence of AF in patients with HF remains unclear.
Does beta-receptor blocker use increase the risk of atrial fibrillation in patients with heart failure?
Cross-Sectional (n=953)
No
Does beta-receptor blocker use increase the risk of atrial fibrillation in patients with heart failure?
Effect estimate: OR 2.821 (95% CI 2.014-3.951)
Absolute Event Rate: 48.9% vs 25.2%
p-value: p=< 0.01
In an observational analysis of the MIMIC-IV database, beta-blocker use was associated with a nearly 3-fold increased risk of atrial fibrillation in patients with heart failure, though this may be subject to confounding by indication.
Beta-blocker use was associated with higher AF risk in HF; leaves open confounding by indication and requires randomized confirmation.
BACKGROUND: The β-receptor blocker is used to treat heart failure (HF), and its role in the occurrence of atrial fibrillation (AF) is unclear in patients with HF. This study aimed to investigate the relationship between β-receptor blocker use and AF in patients with HF. METHODS: All data was collected from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. The relationship between β-receptor blocker and AF was analyzed by univariate logistic regression, multivariate logistic regression, and subgroup analysis. The machine learning algorithm including logistic and Random forest was used to analyze the importance of variables in AF. The interaction analysis was conducted to determine whether other factors influence the relationship between β-receptor blocker and AF. RESULTS: A total of 953 participants were involved. We found that the use of beta-blockers increased the risk of AF this result was not affected by confounding factors (OR (95%CI): 2.821[2.014,3.951], p < 0.01). The interaction analysis showed that myocardial infarction (MI) and β-receptor blocker had an interaction on AF (p for interaction < 0.001). The results of additive and multiplicative interaction analysis indicated that β-receptor-blocker use and infarction are antagonistic in the development of AF in patients with HF ((S (95% CI): 0.283[0.142, 0.563]; AP (95% CI): -1.187[-2.020, -0.354]; RERI (95% CI): -2.237[-3.722, -0.752], OR (95% CI):0.374[0.184, 0.772]). CONCLUSION: This study found that β-receptor blocker use was an important risk factor for AF in patients with HF. β-receptor blocker use was antagonistic to MI in AF in patients with HF. CLINICAL TRIAL: Not applicable.
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Wang et al. (2025) conducted a cross-sectional in Heart failure (n=953). β-receptor blocker vs. No β-receptor blocker was evaluated on Occurrence of atrial fibrillation (OR 2.821, 95% CI 2.014-3.951, p=< 0.01). β-receptor blocker use significantly increased the risk of atrial fibrillation in patients with heart failure (OR 2.821), and exhibited an antagonistic interaction with myocardial infarction.
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