Beta Blockers reduce Mortality in Heart Failure Patients with CKD, claims study
Current national guidelines recommend that clinicians treat patients with heart failure and left ventricular systolic dysfunction with β-adrenergic receptor blockers (β-blockers), based on robust evidence from several randomized clinical trials showing a reduction in mortality and morbidity. More than two-thirds of patients with heart failure also have chronic kidney disease (CKD),...
Current national guidelines recommend that clinicians treat patients with heart failure and left ventricular systolic dysfunction with β-adrenergic receptor blockers (β-blockers), based on robust evidence from several randomized clinical trials showing a reduction in mortality and morbidity. More than two-thirds of patients with heart failure also have chronic kidney disease (CKD), which independently increases the risk of adverse cardiovascular events and death.
According to a new study published in the American Journal of Kidney Diseases, β-blockers have been associated with a lower rate of mortality among incident hemodialysis patients with Heart failure.
To date,β-blockers are recommended for heart failure (HF) patients but their benefit in the dialysis population is uncertain. β-blockers are heterogeneous including concerning their removal by hemodialysis.
With this in view, researchers sought to evaluate whether β-blocker use and their dialyzability characteristics were associated with early mortality among chronic kidney disease (CKD) patients with HF who transitioned to dialysis.
The research team made undertook a Retrospective cohort study with participants as adult patients with CKD (age ≥ 18 years) and HF who initiated either hemodialysis or peritoneal dialysis during 1/1/2007-6/30/2016 within an integrated health system.
Patients were considered treated with β-blockers if they had a quantity of drug dispensed covering the dialysis transition date.
The primary outcome that was evaluated was all-cause mortality within 6 months and 1 year, or hospitalization within 6 months after transitioning to maintenance dialysis.
On data analysis, the following facts emerged.
- A total of 3,503 patients were included in the study.
- There were 2,115 (60.4%) patients on β-blockers at transition.
- Compared to non-users, the hazard ratio for all-cause mortality within 6 months was 0.79 (95% CI: 0.65-0.94) among users of any β-blocker, and 0.68 (95% CI: 0.53-0.88) among users of metoprolol at transition.
- There were no observed differences in all-cause or cardiovascular-related hospitalization.
For the full article click on the link: https://doi.org/10.1053/j.ajkd.2020.07.023
Primary source: American Journal of Kidney Diseases
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