open access

Vol 26, No 6 (2019)
Original articles — Clinical cardiology
Published online: 2018-07-13
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The effect of beta-blockers on mortality in patients with heart failure and atrial fibrillation: A meta-analysis of observational cohort and randomized controlled studies

Gai-gai Ma, Quan Fang, Feng-xia Wang
DOI: 10.5603/CJ.a2018.0074
·
Pubmed: 30009373
·
Cardiol J 2019;26(6):744-752.

open access

Vol 26, No 6 (2019)
Original articles — Clinical cardiology
Published online: 2018-07-13

Abstract

Background: Beta-blockers (BB) are the cornerstone of therapy for heart failure (HF); however, the
effects of these drugs on the prognosis of patients with concomitant atrial fibrillation (AF) remain
controversial. The objective of this meta-analysis was to evaluate the efficacy of BB on mortality in HF
coexisting with AF.
Methods: A systematic search of PubMed, Embase and the Cochrane Library databases was
conducted. Observational cohort studies and randomized controlled trials reporting outcomes of
mortality or HF hospitalizations for patients with HF and AF, being assigned to BB treatment.
A non-BB group was also included.
Results: A total of 8 clinical studies (5 randomized controlled trials and 3 observational cohort studies)
involving 34197 patients were included in the analysis. The pooled analysis demonstrated that BB
treatment was associated with a 22% reduction in relative risk of all-cause mortality in patients with
HF and AF (RR: 0.78; 95% CI 0.71–0.86; p < 0.00001; I2 = 27%). The pooled analysis of 5 studies
reported the outcome of HF hospitalization (2774 patients) which showed that BB therapy was not associated
with a reduction of HF hospitalizations (RR: 0.94; 95% CI 0.79–1.11; p = 0.46; I2 = 38%).
Conclusions: Meta-analysis suggests the potential mortality benefit of BB in patients with HF and AF.
It was concluded herein that it is premature to deny patients with AF and HF to receive BB therapy
considering current evidence.

Abstract

Background: Beta-blockers (BB) are the cornerstone of therapy for heart failure (HF); however, the
effects of these drugs on the prognosis of patients with concomitant atrial fibrillation (AF) remain
controversial. The objective of this meta-analysis was to evaluate the efficacy of BB on mortality in HF
coexisting with AF.
Methods: A systematic search of PubMed, Embase and the Cochrane Library databases was
conducted. Observational cohort studies and randomized controlled trials reporting outcomes of
mortality or HF hospitalizations for patients with HF and AF, being assigned to BB treatment.
A non-BB group was also included.
Results: A total of 8 clinical studies (5 randomized controlled trials and 3 observational cohort studies)
involving 34197 patients were included in the analysis. The pooled analysis demonstrated that BB
treatment was associated with a 22% reduction in relative risk of all-cause mortality in patients with
HF and AF (RR: 0.78; 95% CI 0.71–0.86; p < 0.00001; I2 = 27%). The pooled analysis of 5 studies
reported the outcome of HF hospitalization (2774 patients) which showed that BB therapy was not associated
with a reduction of HF hospitalizations (RR: 0.94; 95% CI 0.79–1.11; p = 0.46; I2 = 38%).
Conclusions: Meta-analysis suggests the potential mortality benefit of BB in patients with HF and AF.
It was concluded herein that it is premature to deny patients with AF and HF to receive BB therapy
considering current evidence.

Get Citation

Keywords

beta-blocker, atrial fibrillation, heart failure, mortality

About this article
Title

The effect of beta-blockers on mortality in patients with heart failure and atrial fibrillation: A meta-analysis of observational cohort and randomized controlled studies

Journal

Cardiology Journal

Issue

Vol 26, No 6 (2019)

Pages

744-752

Published online

2018-07-13

DOI

10.5603/CJ.a2018.0074

Pubmed

30009373

Bibliographic record

Cardiol J 2019;26(6):744-752.

Keywords

beta-blocker
atrial fibrillation
heart failure
mortality

Authors

Gai-gai Ma
Quan Fang
Feng-xia Wang

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