Clin Res Cardiol (2021). 10.1007/s00392-021-01933-9

Prognostic Value of Beta-blocker Doses in Patients with Ventricular Tachyarrhythmias
T. Schupp1, S. Ziyadova1, J. Reinhardt1, Y. U. Sag1, M. von Zworowsky1, L. Reiser1, M. Abumayyaleh1, K. J. Weidner1, K. A. Mashayekhi2, T. Bertsch3, I. Akin1, M. Behnes1
1I. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim; 2Klinik für Kardiologie und Angiologie II, Universitäts-Herzzentrum Freiburg / Bad Krozingen, Bad Krozingen; 3Institut für klinische Chemie und Laboratoriumsmedizin und Transfusionsmedizin, Klinikum Nürnberg Nord, Nürnberg;
Objective: The study investigates the prognostic significance of beta-blocker (BB) dose in patients with ventricular tachyarrhythmias.

Background: Limited data regarding the prognostic value of BB dose in ventricular tachyarrhythmias is available.

Methods: A large retrospective registry was used including consecutive patients on BB treatment with episodes of ventricular tachycardia (VT) or fibrillation (VF) from 2002 to 2015. Discharge BB doses were grouped as >0% to 12.5%, >12.5% to 25%, >25% to 50%, and >50% according to BB doses used in randomized trials. The primary prognostic outcome was all-cause mortality at three years. Secondary endpoints comprised of a composite arrhythmic endpoint (i.e., recurrences of ventricular tachyarrhythmias, sudden cardiac death) and cardiac rehospitalization. Kaplan Meier survival curves and multivariable Cox regression analyses were applied for statistics.

Results: 1,313 patients with BB were included, most patients were discharged with >25-50% of BB target dose (59%). At three years, >12.5-25% of BB target dose was associated with improved long-term mortality as compared to the >0-12.5% group (HR=0.489; 95% CI 0.297-0.806; p=0.005), whereas higher BB doses did not improve survival (>25-50%: HR=0.849; p=0.434; >50%: HR=0.735; p=0.285). In contrast, the composite endpoint and risk of rehospitalization were not affected by BB target dose.

Conculsion: >12.5-25% of BB target dose is associated with best long-term survival among patients with ventricular tachyarrhythmias.

https://dgk.org/kongress_programme/ht2021/P62.htm