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  • Beta blockers may...

Beta blockers may reduce mortality in cluster of young patients with AF and HF: Lancet

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-09-02T10:45:51+05:30  |  Updated On 2 Sept 2021 1:42 PM IST
Beta blockers may reduce mortality in cluster of young patients with AF and HF: Lancet
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A statistically significant reduction in mortality is associated with beta blockers in a cluster of younger atrial fibrillation patients at lower mortality risk but similar LVEF to average, according to a study published in The Lancet.

Mortality remains unacceptably high in patients with heart failure and reduced left ventricular ejection fraction (LVEF) despite advances in therapeutics.

A group of researchers from the U.K hypothesised that a novel artificial intelligence approach could better assess multiple and higher-dimension interactions of comorbidities, and define clusters of β-blocker efficacy in patients with sinus rhythm and atrial fibrillation.

The researchers applied neural network-based variational autoencoders and hierarchical clustering to pooled individual patient data from nine double-blind, randomised, placebo-controlled trials of β blockers.

All-cause mortality during median 1·3 years of follow-up was assessed by intention to treat, stratified by electrocardiographic heart rhythm.

The number of clusters and dimensions were determined objectively, with results validated using a leave-one-trial-out approach.

The results of the study are as follows:

  • 15 659 patients with heart failure and LVEF of less than 50% were included, with median age 65 years and LVEF 27%, 3708 (24%) patients were women. In sinus rhythm, most clusters demonstrated a consistent overall mortality benefit from β blockers.
  • One cluster in sinus rhythm of older patients with less severe symptoms showed no significant efficacy.
  • In atrial fibrillation, four of five clusters were consistent with the overall neutral effect of β blockers versus placebo.
  • One cluster of younger atrial fibrillation patients at lower mortality risk but similar LVEF to average had a statistically significant reduction in mortality with β blockers.
  • The robustness and consistency of clustering was confirmed for all models and cluster membership was externally validated across the nine independent trials.

Thus, the researchers concluded that an artificial intelligence-based clustering approach was able to distinguish the prognostic response from β blockers in patients with heart failure and reduced LVEF. This included patients in sinus rhythm with suboptimal efficacy, as well as a cluster of patients with atrial fibrillation where β blockers did reduce mortality.

Reference:

Redefining β-blocker response in heart failure patients with sinus rhythm and atrial fibrillation: a machine-learning cluster analysis by Karwath A et. al published in The Lancet.

DOI: https://doi.org/10.1016/S0140-6736(21)01638-X



heart failureβ-blockerthe lancetsinus rhythmatrial fibrillation
Source : The Lancet
Dr. Shravani Dali
Dr. Shravani Dali

    Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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