Beta-blockers and Ambulatory Inotropic Therapy.
Citation: Journal of Cardiac Failure. 2022 Apr 18PMID: 35447337Institution: MedStar Health Research Institute | MedStar Heart & Vascular InstituteDepartment: Internal Medicine Residency | MedStar Georgetown University Hospital/MedStar Washington Hospital CenterForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2022ISSN:- 1071-9164
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 35447337 | Available | 35447337 |
BACKGROUND: Continuous infusion of ambulatory inotropic therapy (AIT) is increasingly used in patients with end stage heart failure (HF). There is a paucity of data on the concomitant use of beta blockers (BB) in these patients.
CONCLUSION: In patients with end-stage heart failure on AIT, the use of BB with inotropes was associated with lower HF hospitalizations and ventricular arrhythmias. Copyright © 2022. Published by Elsevier Inc.
METHODS: We retrospectively reviewed all patients discharged from our institution on AIT. The cohort was stratified into two groups based on BB use. The 2 groups were compared for differences in HF hospitalizations, ventricular arrhythmias, and ICD therapies (shock or anti-tachycardia pacing).
RESULTS: Between 2010 and 2017, 349 patients were discharged on AIT (95% on Milrinone), 74% were males with a mean age of 61 +/-14 years. BB were used in 195 (56%) patients, whereas 154 (44%) did not receive these medications. Patients in the BB-group had longer duration of AIT support compared to those in the non-BB group (141 [1-2114] vs. 68 [1-690] days). After adjusting for differences in baseline characteristics and indication for AIT, patients in the BB-group had significantly lower rates of HF-hospitalizations (hazard ratio (HR) 0.61 [0.43-0.86], p= 0.005), ventricular arrhythmias (HR 0.34 [0.15-0.74], p=0.007)and ICD therapies (HR 0.24 [0.07-0.79], p=0.02).
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