Clin Res Cardiol (2021). 10.1007/s00392-021-01933-9 |
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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. |
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https://dgk.org/kongress_programme/ht2021/P62.htm |