Effects of beta-blockers on heart failure with preserved ejection fraction: a meta-analysis

PLoS One. 2014 Mar 5;9(3):e90555. doi: 10.1371/journal.pone.0090555. eCollection 2014.

Abstract

Background: Effects of beta-blockers on the prognosis of the heart failure patients with preserved ejection fraction (HFpEF) remain controversial. The aim of this meta-analysis was to determine the impact of beta-blockers on mortality and hospitalization in the patients with HFpEF.

Methods: A search of MEDLINE, EMBASE, and the Cochrane Library databases from 2005 to June 2013 was conducted. Clinical studies reporting outcomes of mortality and/or hospitalization for patients with HFpEF (EF ≥ 40%), being assigned to beta-blockers treatment and non-beta-blockers control group were included.

Results: A total of 12 clinical studies (2 randomized controlled trials and 10 observational studies) involving 21,206 HFpEF patients were included for this meta-analysis. The pooled analysis demonstrated that beta-blocker exposure was associated with a 9% reduction in relative risk for all-cause mortality in patients with HFpEF (95% CI: 0.87 - 0.95; P < 0.001). Whereas, the all-cause hospitalization, HF hospitalization and composite outcomes (mortality and hospitalization) were not affected by this treatment (P=0.26, P=0.97, and P=0.88 respectively).

Conclusions: The beta-blockers treatment for the patients with HFpEF was associated with a lower risk of all-cause mortality, but not with a lower risk of hospitalization. These finding were mainly obtained from observational studies, and further investigations are needed to make an assertion.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Cardiovascular Agents / therapeutic use*
  • Heart Failure / drug therapy*
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Hospitalization
  • Humans
  • Prognosis
  • Stroke Volume
  • Survival Analysis
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists
  • Cardiovascular Agents

Grant support

This work was supported by grants from National Basic Research Program of China (973 Program) (No. 2013CB733804), National Natural Science Foundation of China (No. 81227801 and No. 81271640), and the Team Program of Natural Science Foundation of Guangdong Province, China (S2011030003134) to Jianping Bin. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.