Why the study?
Mortality remains high in heart failure with reduced LVEF, prompting exploration into whether artificial intelligence could better assess complex comorbidity interactions to define clusters of β-blocker efficacy in sinus rhythm and atrial fibrillation.
Do beta-blockers reduce all-cause mortality in specific machine-learning derived clusters of heart failure patients with reduced LVEF in sinus rhythm and atrial fibrillation?
Population
15 659 patients with heart failure and LVEF <50%
Comparison
β blockers vs placebo
Design
Individual patient data analysis of nine double-blind randomised placebo-controlled trials
Follow-up
Median 1·3 years
Authors
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Beta-blockers reduce mortality in HFrEF sinus rhythm; extends evidence by identifying an AF cluster deriving benefit.
Do beta-blockers reduce all-cause mortality in specific machine-learning derived clusters of heart failure patients with reduced LVEF in sinus rhythm and atrial fibrillation?
Machine learning clustering identified specific subgroups of HFrEF patients with differing prognostic responses to beta-blockers, including a subset of atrial fibrillation patients who derive significant mortality benefit despite the overall neutral effect in this population.
Karwath et al. (2021) studied this question.
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