Why the study?
Does beta-blocker therapy dose and discharge heart rate affect long-term outcomes in Japanese patients with acute heart failure?
Does beta-blocker therapy dose and discharge heart rate affect long-term outcomes in Japanese patients with acute heart failure?
Optimizing heart rate, rather than maximizing beta-blocker dose, appears to be an appropriate treatment strategy for Japanese patients with acute heart failure.
May support discharge HR optimization in acute HF; hypothesis-generating for beta-blocker strategies in Japanese patients.
Background: Randomized trials have demonstrated the efficacy of beta-blockers (BBs) in heart failure (HF) patients. We sought to assess the impact of BBs on long-term outcome; in particular, we assessed the association between outcome and BB dose and discharge heart rate. Methods and Results: Prescriptions for dispensed medication and outcomes were identified from a prospective, single-institution HF registry. Long-term prognosis was compared between users and non-users of BBs. BB users were further divided into 2 groups based on dose (full and non-full dose) and discharge heart rate (70 bpm was significantly associated with impaired long-term outcome (HR = 1.872, P = 0.04). Conclusions: Optimizing heart rate, rather than maximizing BB dose, appears to be an appropriate treatment strategy for the beta-sensitive Japanese population.
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Oshima et al. (2013) studied this question.
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