Prognostic Significance of Resting Heart Rate and Use of beta-Blockers in Atrial Fibrillation and Sinus Rhythm in Patients With Heart Failure and Reduced Ejection Fraction: Findings From the Swedish Heart Failure Registry
Journal article, 2015
BACKGROUND: In heart failure and reduced ejection fraction, the prognostic role of heart rate (HR) in atrial fibrillation (AF) is unknown and the effectiveness of beta-blockers has recently been questioned in AF. METHODS AND RESULTS: A total of 18 858 patients with heart failure and reduced ejection fraction registered with Swedish Heart Failure Registry were included in this study: patients with sinus rhythm (SR; n=11 466) and patients with AF (n=7392). The outcome measure was all-cause mortality. Compared with HR 100 beats per minute. However, in AF, the hazard ratio increased only for HR >100 beats per minute (1.30; P=0.001). beta-blocker use was associated with reduced mortality in SR (hazard ratio, 0.77; P=0.011) and in AF (hazard ratio, 0.71; P<0.001). For beta-blocker use in SR, the hazard ratio gradually increased with HR increment, whereas in AF, the hazard ratio significantly increased only for HR >100 beats per minute (1.29; P=0.003) compared with HR 100 beats per minute. beta-blocker use was associated with reduced mortality both in SR and in AF.
Aged
Middle Aged
Treatment Outcome
Heart Rate/drug effects/*physiology
Stroke Volume/*physiology
*Registries
Adrenergic beta-Antagonists/*therapeutic use
Heart Failure/complications/drug therapy/*physiopathology
Prognosis
Rest/*physiology
Aged
Humans
Male
Atrial Fibrillation/complications/drug therapy/*physiopathology
80 and over
Female
Author
S. J. Li
U. Sartipy
L. H. Lund
U. Dahlstrom
Martin Adiels
University of Gothenburg
Max Petzold
University of Gothenburg
Michael Fu
Circulation. Heart failure
1941-3289 (ISSN) 1941-3297 (eISSN)
Vol. 8 5 871-9Subject Categories
Clinical Medicine
DOI
10.1161/CIRCHEARTFAILURE.115.002285
PubMed
26243796