Beta-blockers reduce mortality risk, but not readmission, in older patients with HFrEF

Use of beta-blockers results in a lower risk of all-cause mortality, but not of heart failure (HF) readmission, in older patients with HR with reduced ejection fraction (HFrEF), reports a recent study. Results are similar between patients admitted and not admitted from nursing homes.

A team of investigators assembled a propensity score-matched balanced cohort of 6,494 hospitalized patients aged ≥65 years with HFrEF (ejection fraction ≤40 percent) from the combined OPTIMIZE-HF and Alabama Heart Failure Project data sets.

In the primary approach, the investigators estimated hazard ratios (HRs) and 95 percent confidence intervals (CIs) for outcomes associated with discharge prescriptions for beta-blockers, examining for heterogeneity by admission from nursing homes. In the sensitivity approach, they evaluated these associations in a separately assembled cohort of 122 patients admitted from nursing homes.

In the matched primary cohort of 6,494 patients, HRs were 0.80 (95 percent CI, 0.74‒0.87) for 12-month all-cause mortality and 0.94 (95 percent CI, 0.86‒1.02) for HF readmission. In the nursing and non-nursing home subgroups, the respective HRs were 0.77 (95 percent CI, 0.51‒1.16) and 0.81 (95 percent CI, 0.74‒0.87) for all-cause mortality (p_interaction=0.653) and 1.06 (95 percent CI, 0.53‒2.12) and 0.89 (95 percent CI, 0.82‒0.96) for HF readmission (p_interaction=0.753).

In the matched sensitivity cohort of 122 patients admitted from nursing homes, HRs were 0.86 (95 percent CI, 0.55‒1.35) for 12-month all-cause mortality and 1.07 (95 percent CI, 0.52‒2.22) for HF readmission. Associations observed for 30-day outcomes were similar.

“Beta-blockers improve clinical outcomes in patients with HFrEF,” the investigators said.