Has Beta-blocker Use Increased in Patients With Heart Failure in Internal Medicine Settings? Prognostic Implications: RICA Registry
Underuse of beta-blockers has been reported in elderly patients with heart failure. The aim of this study was to evaluate the current prescription of beta-blockers in the internal medicine setting, and its association with morbidity and mortality in heart failure patients. The information analyzed w...
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| Veröffentlicht in: | Revista española de cardiología (English ed.) 2014-03, Vol.67 (3), p.196-202 |
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| creator | González-García, Andrés Montero Pérez-Barquero, Manuel Formiga, Francesc González-Juanatey, José R. Quesada, M. Angustias Epelde, Francisco Oropesa, Roberto Díez-Manglano, Jesús Cerqueiro, José M. Manzano, Luis |
| description | Underuse of beta-blockers has been reported in elderly patients with heart failure. The aim of this study was to evaluate the current prescription of beta-blockers in the internal medicine setting, and its association with morbidity and mortality in heart failure patients.
The information analyzed was obtained from a prospective cohort of patients hospitalized for heart failure (RICA registry] database, patients included from March 2008 to September 2011) with at least one year of follow-up. We investigated the percentage of patients prescribed beta-blockers at hospital discharge, and at 3 and 12 months, and the relationship of beta-blocker use with mortality and readmissions for heart failure. Patients with significant valve disease were excluded.
A total of 515 patients were analyzed (53.5% women), with a mean age of 77.1 (8.7) years. Beta-blockers were prescribed in 62.1% of patients at discharge. A similar percentage was found at 3 months (65.6%) and 12 months (67.9%) after discharge. All-cause mortality and the composite of all-cause mortality and readmission for heart failure were significantly lower in patients treated with beta-blockers (hazard ratio=0.59, 95% confidence interval, 0.41-0.84 vs hazard ratio=0.64, 95% confidence interval, 0.49-0.83). This decrease in mortality was maintained after adjusting by age, sex, ejection fraction, functional class, comorbidities, and concomitant treatment.
The findings of this study indicate that beta-blocker use is increasing in heart failure patients (mainly elderly) treated in the internal medicine setting, and suggest that the use of these drugs is associated with a reduction in clinical events.
Se ha descrito una infrautilización de bloqueadores beta en pacientes de edad avanzada con insuficiencia cardiaca. El objetivo es determinar el grado de prescripción actual de bloqueadores beta en servicios de medicina interna y su asociación con la morbimortalidad.
La información analizada se obtuvo de los datos de una cohorte prospectiva de pacientes hospitalizados por insuficiencia cardiaca (registro RICA, incluidos entre marzo de 2008 y septiembre de 2011) con al menos 1 año de seguimiento. Se evaluaron los porcentajes de prescripción de bloqueadores beta al alta hospitalaria, a los 3 meses y al año, y su asociación con la mortalidad y los reingresos hospitalarios. Se excluyó a los pacientes con valvulopatía significativa.
Se analizó a 515 pacientes (el 53,5% mujeres; media de edad, 77,1 ± 8,7 años). La prescr |
| doi_str_mv | 10.1016/j.rec.2013.07.012 |
| format | Article |
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The information analyzed was obtained from a prospective cohort of patients hospitalized for heart failure (RICA registry] database, patients included from March 2008 to September 2011) with at least one year of follow-up. We investigated the percentage of patients prescribed beta-blockers at hospital discharge, and at 3 and 12 months, and the relationship of beta-blocker use with mortality and readmissions for heart failure. Patients with significant valve disease were excluded.
A total of 515 patients were analyzed (53.5% women), with a mean age of 77.1 (8.7) years. Beta-blockers were prescribed in 62.1% of patients at discharge. A similar percentage was found at 3 months (65.6%) and 12 months (67.9%) after discharge. All-cause mortality and the composite of all-cause mortality and readmission for heart failure were significantly lower in patients treated with beta-blockers (hazard ratio=0.59, 95% confidence interval, 0.41-0.84 vs hazard ratio=0.64, 95% confidence interval, 0.49-0.83). This decrease in mortality was maintained after adjusting by age, sex, ejection fraction, functional class, comorbidities, and concomitant treatment.
The findings of this study indicate that beta-blocker use is increasing in heart failure patients (mainly elderly) treated in the internal medicine setting, and suggest that the use of these drugs is associated with a reduction in clinical events.
Se ha descrito una infrautilización de bloqueadores beta en pacientes de edad avanzada con insuficiencia cardiaca. El objetivo es determinar el grado de prescripción actual de bloqueadores beta en servicios de medicina interna y su asociación con la morbimortalidad.
La información analizada se obtuvo de los datos de una cohorte prospectiva de pacientes hospitalizados por insuficiencia cardiaca (registro RICA, incluidos entre marzo de 2008 y septiembre de 2011) con al menos 1 año de seguimiento. Se evaluaron los porcentajes de prescripción de bloqueadores beta al alta hospitalaria, a los 3 meses y al año, y su asociación con la mortalidad y los reingresos hospitalarios. Se excluyó a los pacientes con valvulopatía significativa.
Se analizó a 515 pacientes (el 53,5% mujeres; media de edad, 77,1 ± 8,7 años). La prescripción de bloqueadores beta al alta hospitalaria fue del 62,1%. Durante el seguimiento, este porcentaje de prescripción fue similar tanto a los 3 meses (65,6%) como al año (67,9%). La mortalidad total y la variable combinada de mortalidad total y reingresos por insuficiencia cardiaca fue significativamente inferior entre los pacientes tratados que en los no tratados (hazard ratio = 0,59; intervalo de confianza del 95%, 0,41-0,84 frente a hazard ratio = 0,64; intervalo de confianza del 95%, 0,49-0,83). La disminución de la mortalidad se mantuvo tras ajustar por edad, sexo, fracción de eyección, clase funcional, comorbilidades y tratamiento concomitante.
Los datos del estudio indican incremento en la utilización de bloqueadores beta en pacientes mayoritariamente ancianos con insuficiencia cardiaca atendidos en servicios de medicina interna, y su implementación probablemente se asocia a una reducción de los eventos clínicos.</description><identifier>ISSN: 1885-5857</identifier><identifier>EISSN: 1885-5857</identifier><identifier>DOI: 10.1016/j.rec.2013.07.012</identifier><identifier>PMID: 24774394</identifier><language>eng</language><publisher>Spain: Elsevier Espana</publisher><subject>Adrenergic beta-Antagonists - therapeutic use ; Aged ; Anciano ; Beta-blocker agents ; Bloqueadores beta ; Drug Prescriptions - statistics & numerical data ; Elderly ; Female ; Heart failure ; Heart Failure - drug therapy ; Heart Failure - epidemiology ; Humans ; Insuficiencia cardiaca ; Internal Medicine ; Male ; Patient Readmission - statistics & numerical data ; Registries ; Registro RICA ; RICA registry ; Spain - epidemiology ; Tratamiento ; Treatment</subject><ispartof>Revista española de cardiología (English ed.), 2014-03, Vol.67 (3), p.196-202</ispartof><rights>2013 Sociedad Española de Cardiología</rights><rights>Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c305t-bb06ec9995dd96336698a012e41cd3cc9a519bd66d1bdcd7d542fb57097d433f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1885585713002910$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24774394$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>González-García, Andrés</creatorcontrib><creatorcontrib>Montero Pérez-Barquero, Manuel</creatorcontrib><creatorcontrib>Formiga, Francesc</creatorcontrib><creatorcontrib>González-Juanatey, José R.</creatorcontrib><creatorcontrib>Quesada, M. Angustias</creatorcontrib><creatorcontrib>Epelde, Francisco</creatorcontrib><creatorcontrib>Oropesa, Roberto</creatorcontrib><creatorcontrib>Díez-Manglano, Jesús</creatorcontrib><creatorcontrib>Cerqueiro, José M.</creatorcontrib><creatorcontrib>Manzano, Luis</creatorcontrib><creatorcontrib>on behalf of the RICA registry investigators</creatorcontrib><creatorcontrib>RICA registry investigators</creatorcontrib><title>Has Beta-blocker Use Increased in Patients With Heart Failure in Internal Medicine Settings? Prognostic Implications: RICA Registry</title><title>Revista española de cardiología (English ed.)</title><addtitle>Rev Esp Cardiol (Engl Ed)</addtitle><description>Underuse of beta-blockers has been reported in elderly patients with heart failure. The aim of this study was to evaluate the current prescription of beta-blockers in the internal medicine setting, and its association with morbidity and mortality in heart failure patients.
The information analyzed was obtained from a prospective cohort of patients hospitalized for heart failure (RICA registry] database, patients included from March 2008 to September 2011) with at least one year of follow-up. We investigated the percentage of patients prescribed beta-blockers at hospital discharge, and at 3 and 12 months, and the relationship of beta-blocker use with mortality and readmissions for heart failure. Patients with significant valve disease were excluded.
A total of 515 patients were analyzed (53.5% women), with a mean age of 77.1 (8.7) years. Beta-blockers were prescribed in 62.1% of patients at discharge. A similar percentage was found at 3 months (65.6%) and 12 months (67.9%) after discharge. All-cause mortality and the composite of all-cause mortality and readmission for heart failure were significantly lower in patients treated with beta-blockers (hazard ratio=0.59, 95% confidence interval, 0.41-0.84 vs hazard ratio=0.64, 95% confidence interval, 0.49-0.83). This decrease in mortality was maintained after adjusting by age, sex, ejection fraction, functional class, comorbidities, and concomitant treatment.
The findings of this study indicate that beta-blocker use is increasing in heart failure patients (mainly elderly) treated in the internal medicine setting, and suggest that the use of these drugs is associated with a reduction in clinical events.
Se ha descrito una infrautilización de bloqueadores beta en pacientes de edad avanzada con insuficiencia cardiaca. El objetivo es determinar el grado de prescripción actual de bloqueadores beta en servicios de medicina interna y su asociación con la morbimortalidad.
La información analizada se obtuvo de los datos de una cohorte prospectiva de pacientes hospitalizados por insuficiencia cardiaca (registro RICA, incluidos entre marzo de 2008 y septiembre de 2011) con al menos 1 año de seguimiento. Se evaluaron los porcentajes de prescripción de bloqueadores beta al alta hospitalaria, a los 3 meses y al año, y su asociación con la mortalidad y los reingresos hospitalarios. Se excluyó a los pacientes con valvulopatía significativa.
Se analizó a 515 pacientes (el 53,5% mujeres; media de edad, 77,1 ± 8,7 años). La prescripción de bloqueadores beta al alta hospitalaria fue del 62,1%. Durante el seguimiento, este porcentaje de prescripción fue similar tanto a los 3 meses (65,6%) como al año (67,9%). La mortalidad total y la variable combinada de mortalidad total y reingresos por insuficiencia cardiaca fue significativamente inferior entre los pacientes tratados que en los no tratados (hazard ratio = 0,59; intervalo de confianza del 95%, 0,41-0,84 frente a hazard ratio = 0,64; intervalo de confianza del 95%, 0,49-0,83). La disminución de la mortalidad se mantuvo tras ajustar por edad, sexo, fracción de eyección, clase funcional, comorbilidades y tratamiento concomitante.
Los datos del estudio indican incremento en la utilización de bloqueadores beta en pacientes mayoritariamente ancianos con insuficiencia cardiaca atendidos en servicios de medicina interna, y su implementación probablemente se asocia a una reducción de los eventos clínicos.</description><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Aged</subject><subject>Anciano</subject><subject>Beta-blocker agents</subject><subject>Bloqueadores beta</subject><subject>Drug Prescriptions - statistics & numerical data</subject><subject>Elderly</subject><subject>Female</subject><subject>Heart failure</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Failure - epidemiology</subject><subject>Humans</subject><subject>Insuficiencia cardiaca</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Registries</subject><subject>Registro RICA</subject><subject>RICA registry</subject><subject>Spain - epidemiology</subject><subject>Tratamiento</subject><subject>Treatment</subject><issn>1885-5857</issn><issn>1885-5857</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEFvFCEUgInR2Fr9AV4MRy8zwgDDoAdTG-tuUmNTbTwSBt6urLPMymNNevaPy2ar8eQJEr73hfcR8pyzljPev9q0GXzbMS5aplvGuwfklA-DatSg9MN_7ifkCeKGMSUGLR-Tk05qLYWRp-TXwiF9B8U14zT775DpLQJdJp_BIQQaE712JUIqSL_G8o0uwOVCL12c9hkOz8tUICc30Y8Qoo8J6GcoJaY1vqXXeV6nGUv0dLndTdFX1ZzwNb1ZXpzTG1hHLPnuKXm0chPCs_vzjNxevv9ysWiuPn2o3FXjBVOlGUfWgzfGqBBML0Tfm8HVpUFyH4T3xiluxtD3gY_BBx2U7Faj0szoIIVYiTPy8ujd5fnHHrDYbUQP0-QSzHu0XNWUvJNcVpQfUZ9nxAwru8tx6_Kd5cwe2tuNre3tob1l2tZv1JkX9_r9uIXwd-JP7Aq8OQJQl_wZIVv0tayv3aqr2DDH_-h_A5wRlUQ</recordid><startdate>201403</startdate><enddate>201403</enddate><creator>González-García, Andrés</creator><creator>Montero Pérez-Barquero, Manuel</creator><creator>Formiga, Francesc</creator><creator>González-Juanatey, José R.</creator><creator>Quesada, M. Angustias</creator><creator>Epelde, Francisco</creator><creator>Oropesa, Roberto</creator><creator>Díez-Manglano, Jesús</creator><creator>Cerqueiro, José M.</creator><creator>Manzano, Luis</creator><general>Elsevier Espana</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201403</creationdate><title>Has Beta-blocker Use Increased in Patients With Heart Failure in Internal Medicine Settings? Prognostic Implications: RICA Registry</title><author>González-García, Andrés ; Montero Pérez-Barquero, Manuel ; Formiga, Francesc ; González-Juanatey, José R. ; Quesada, M. 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Angustias</creatorcontrib><creatorcontrib>Epelde, Francisco</creatorcontrib><creatorcontrib>Oropesa, Roberto</creatorcontrib><creatorcontrib>Díez-Manglano, Jesús</creatorcontrib><creatorcontrib>Cerqueiro, José M.</creatorcontrib><creatorcontrib>Manzano, Luis</creatorcontrib><creatorcontrib>on behalf of the RICA registry investigators</creatorcontrib><creatorcontrib>RICA registry investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Revista española de cardiología (English ed.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>González-García, Andrés</au><au>Montero Pérez-Barquero, Manuel</au><au>Formiga, Francesc</au><au>González-Juanatey, José R.</au><au>Quesada, M. Angustias</au><au>Epelde, Francisco</au><au>Oropesa, Roberto</au><au>Díez-Manglano, Jesús</au><au>Cerqueiro, José M.</au><au>Manzano, Luis</au><aucorp>on behalf of the RICA registry investigators</aucorp><aucorp>RICA registry investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Has Beta-blocker Use Increased in Patients With Heart Failure in Internal Medicine Settings? Prognostic Implications: RICA Registry</atitle><jtitle>Revista española de cardiología (English ed.)</jtitle><addtitle>Rev Esp Cardiol (Engl Ed)</addtitle><date>2014-03</date><risdate>2014</risdate><volume>67</volume><issue>3</issue><spage>196</spage><epage>202</epage><pages>196-202</pages><issn>1885-5857</issn><eissn>1885-5857</eissn><abstract>Underuse of beta-blockers has been reported in elderly patients with heart failure. The aim of this study was to evaluate the current prescription of beta-blockers in the internal medicine setting, and its association with morbidity and mortality in heart failure patients.
The information analyzed was obtained from a prospective cohort of patients hospitalized for heart failure (RICA registry] database, patients included from March 2008 to September 2011) with at least one year of follow-up. We investigated the percentage of patients prescribed beta-blockers at hospital discharge, and at 3 and 12 months, and the relationship of beta-blocker use with mortality and readmissions for heart failure. Patients with significant valve disease were excluded.
A total of 515 patients were analyzed (53.5% women), with a mean age of 77.1 (8.7) years. Beta-blockers were prescribed in 62.1% of patients at discharge. A similar percentage was found at 3 months (65.6%) and 12 months (67.9%) after discharge. All-cause mortality and the composite of all-cause mortality and readmission for heart failure were significantly lower in patients treated with beta-blockers (hazard ratio=0.59, 95% confidence interval, 0.41-0.84 vs hazard ratio=0.64, 95% confidence interval, 0.49-0.83). This decrease in mortality was maintained after adjusting by age, sex, ejection fraction, functional class, comorbidities, and concomitant treatment.
The findings of this study indicate that beta-blocker use is increasing in heart failure patients (mainly elderly) treated in the internal medicine setting, and suggest that the use of these drugs is associated with a reduction in clinical events.
Se ha descrito una infrautilización de bloqueadores beta en pacientes de edad avanzada con insuficiencia cardiaca. El objetivo es determinar el grado de prescripción actual de bloqueadores beta en servicios de medicina interna y su asociación con la morbimortalidad.
La información analizada se obtuvo de los datos de una cohorte prospectiva de pacientes hospitalizados por insuficiencia cardiaca (registro RICA, incluidos entre marzo de 2008 y septiembre de 2011) con al menos 1 año de seguimiento. Se evaluaron los porcentajes de prescripción de bloqueadores beta al alta hospitalaria, a los 3 meses y al año, y su asociación con la mortalidad y los reingresos hospitalarios. Se excluyó a los pacientes con valvulopatía significativa.
Se analizó a 515 pacientes (el 53,5% mujeres; media de edad, 77,1 ± 8,7 años). La prescripción de bloqueadores beta al alta hospitalaria fue del 62,1%. Durante el seguimiento, este porcentaje de prescripción fue similar tanto a los 3 meses (65,6%) como al año (67,9%). La mortalidad total y la variable combinada de mortalidad total y reingresos por insuficiencia cardiaca fue significativamente inferior entre los pacientes tratados que en los no tratados (hazard ratio = 0,59; intervalo de confianza del 95%, 0,41-0,84 frente a hazard ratio = 0,64; intervalo de confianza del 95%, 0,49-0,83). La disminución de la mortalidad se mantuvo tras ajustar por edad, sexo, fracción de eyección, clase funcional, comorbilidades y tratamiento concomitante.
Los datos del estudio indican incremento en la utilización de bloqueadores beta en pacientes mayoritariamente ancianos con insuficiencia cardiaca atendidos en servicios de medicina interna, y su implementación probablemente se asocia a una reducción de los eventos clínicos.</abstract><cop>Spain</cop><pub>Elsevier Espana</pub><pmid>24774394</pmid><doi>10.1016/j.rec.2013.07.012</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1885-5857 |
| ispartof | Revista española de cardiología (English ed.), 2014-03, Vol.67 (3), p.196-202 |
| issn | 1885-5857 1885-5857 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1520112414 |
| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adrenergic beta-Antagonists - therapeutic use Aged Anciano Beta-blocker agents Bloqueadores beta Drug Prescriptions - statistics & numerical data Elderly Female Heart failure Heart Failure - drug therapy Heart Failure - epidemiology Humans Insuficiencia cardiaca Internal Medicine Male Patient Readmission - statistics & numerical data Registries Registro RICA RICA registry Spain - epidemiology Tratamiento Treatment |
| title | Has Beta-blocker Use Increased in Patients With Heart Failure in Internal Medicine Settings? Prognostic Implications: RICA Registry |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-14T12%3A20%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Has%20Beta-blocker%20Use%20Increased%20in%20Patients%20With%20Heart%20Failure%20in%20Internal%20Medicine%20Settings?%20Prognostic%20Implications:%20RICA%20Registry&rft.jtitle=Revista%20espa%C3%B1ola%20de%20cardiolog%C3%ADa%20(English%20ed.)&rft.au=Gonz%C3%A1lez-Garc%C3%ADa,%20Andr%C3%A9s&rft.aucorp=on%20behalf%20of%20the%20RICA%20registry%20investigators&rft.date=2014-03&rft.volume=67&rft.issue=3&rft.spage=196&rft.epage=202&rft.pages=196-202&rft.issn=1885-5857&rft.eissn=1885-5857&rft_id=info:doi/10.1016/j.rec.2013.07.012&rft_dat=%3Cproquest_cross%3E1520112414%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1520112414&rft_id=info:pmid/24774394&rft_els_id=S1885585713002910&rfr_iscdi=true |