B-CONVINCED: Beta-blocker CONtinuation Vs. INterruption in patients with Congestive heart failure hospitalizED for a decompensation episode

Jondeau, Guillaume; Neuder, Yannick; Eicher, Jean‐Christophe; Jourdain, Patrick; Fauveau, Élodie; Galinier, Michel; Jégou, Arnaud; Bauer, Fabrice; Trochu, Jean Noël; Bouzamondo, Anissa; Tanguy, Marie‐Laure; Lechat, Philippe

doi:10.1093/eurheartj/ehp323

Cited by 144 publications

(96 citation statements)

References 22 publications

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“…More importantly, there was no difference in BNP levels, re-hospitalization and mortality in three months. According to our study, patients in the B-CONVINCED that maintained BB during decompensation were using higher doses of medication three months after discharge (90% vs 76%) 17 .…”

Section: Discussionmentioning

confidence: 70%

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É necessário suspender o betabloqueador na insuficiência cardíaca descompensada com baixo débito?

Lima¹,

Cardoso²,

Ochiai³

et al. 2010

Arq. Bras. Cardiol.

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Section: Discussionmentioning

confidence: 70%

“…It prospectively analyzed 147 patients who were hospitalized with decompensated heart failure, an ejection fraction inferior to 40%, previously using betablockers 17 . Patients were divided into two groups according to the maintenance dose of BB on admission or not.…”

Section: Discussionmentioning

confidence: 99%

É necessário suspender o betabloqueador na insuficiência cardíaca descompensada com baixo débito?

Lima¹,

Cardoso²,

Ochiai³

et al. 2010

Arq. Bras. Cardiol.

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show abstract

“…The use of BBs results in a reduction in mortality, morbidity, and hospitalization for HF exacerbation and improves the severity of symptoms [25]. The treatment with BBs should be initiated in stable patients and gradually up-titrated to the maximum tolerated dose, while, in case of exacerbation of chronic HF, it must be reduced or discontinued or not started (like in this case) [26]. Furthermore, the administration of BBs, especially cardioselective ones, in patients with COPD is safe and the presence of a COPD is no longer a contraindication to the use of BBs in a patient with HF [27].…”

Section: While Waiting For the Results Of The Required Clinical Testsmentioning

confidence: 99%

From laboratory to bedside: a case report of a concise and pragmatic approach on heart failure

Pizzini

Martini

2017

CMI

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Heart failure is one of the most common and intensely studied diseases in the world. Nevertheless, it is considered a difficult condition to diagnose and manage. This case report, starting from the description of a brief clinical case, aims to directly and concisely explain the most important steps, from laboratory to bedside, in the diagnosis and management of heart failure disease. Physicians can rely on some laboratory tests (e.g., natriuretic peptides) and instrumental exams to diagnose and manage the patients in everyday medical practice. Finally, this article highlights that a multidisciplinary team management can improve the clinical status and the quality of life, thus preventing hospital admission and reducing mortality in patients with heart failure.

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“…Although there have been studies reporting that starting BB treatment following stabilization in hospitalizations of patients without prior use of BB due to ADHF decreases the mortality rate, the number of studies evaluating the effect of in-hospital initiation of BB on LOS are quite limited. Those studies mentioned that in-hospital initiation of BB did not affect LOS (25,42,43). However, further extensive randomized prospective studies are absolutely necessary on both subjects.…”

Section: Wwweurjhscommentioning

confidence: 99%

Chronic beta blocker therapy before admission influences length of hospital stay among patients with acutely decompensated heart failure

Kaya¹,

Güneş²

2016

Eur J Health Sci

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Objective: Length of stay (LOS) of hospitalizations due to acute decompensated heart failure (ADHF) affects both prognosis and health costs. This study aimed to evaluate the effect of chronic beta blocker (BB) therapy before admission on LOS (Length of stay) in patients with heart failure with reduced ejection fraction (HFrEF) hospitalized due to ADHF (acute decompensated heart failure). Methods: This single-center retrospective observational study included a total of 486 HFrEF patients, who were admitted to the hospital due to acute decompensation, between January 2012 and January 2015.Preadmission BB use was defined as using BB for at least four weeks before hospitalization due to ADHF. Patients were classified into two groups based on preadmission BB use as users and nonusers and all specifications of the patients were compared. Results: Mean age and mean EF of the patients (37% female) were 65±13 years and 31±8, respectively. Median LOS was six days and prolonged LOS was defined as LOS> six days. Univariate analysis demonstrated associations of many clinical factors in addition with preadmission use of BBs with prolonged LOS; however, in the multivariate logistic regression analysis with the forward stepwise method, preadmission BB use (OR=0.474, 95%CI=0.258-0.871, p=0.016), age, presence of Atrial fibrillation, creatinine, and sodium levels remained associated with a risk of prolonged LOS following adjustment; for the variables that were statistically significant in the univariate analysis and for the variables that were significantly different between patients who used BB or not. Conclusion: Preadmission BB use is associated with a decreased risk of prolonged hospitalization independent of other variables in patients with HFrEF hospitalized for ADHF.Keywords: Heart failure, length of stay, beta blocker, hospitalization. ÖZETAmaç: Akut dekompanse kalp yetersizliğine (ADKY) bağlı hastaneye yatışlarda hastanede kalış süresi (HKS) hem prognozu hemde sağlık harcamalarını etkiler. Bu çalışmanın amacı; akut dekompanse kalp yetersizliğine (ADKY) bağlı hastaneye yatırılan azalmış ejeksiyon fraksiyonlu kalp yetersizliği (KY) hastalarında; hastaneye kabul öncesinde beta blokör (BB) kullanımının HKS ye etkisini değerlendirmektir. Yöntemler: Bu tek merkezli geriye dönük gözlemsel çalışmaya; Ocak 2012-Ocak 2015 tarihleri arasında akut dekompansasyona bağlı hastaneye kabul edilen 486 azalmış ejeksiyon fraksiyonlu KY hastası dahil edildi. Hastaneye kabul öncesi BB kullanımı; ADKY bağlı hastaneye yatıştan önce en az 4 haftadır BB kullanıyor olmak olarak tanımlandı. Hastalar; hastaneye kabul öncesi BB kullanımlarına göre; kullananlar ve kullanmayanlar olarak iki gruba ayrıldılar ve tüm özellikleri karşılaştırıldı. Bulgular: Toplam %37'si kadın olan hastaların ortalama yaşları 65±13, ortalama EF leri 31±8 di. HKS nin ortanca değeri 6 gün olup uzamış HKS; HKS> 6 gün olarak tanımlandı. Tek değişkenli regresyon analizinde; hastaneye kabul öncesi BB kullanımının yanı sıra birçok klinik faktör uzamış HKS ile ilişkili bulu...

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B-CONVINCED: Beta-blocker CONtinuation Vs. INterruption in patients with Congestive heart failure hospitalizED for a decompensation episode

Abstract: In conclusion, during ADHF, continuation of beta-blocker therapy is not associated with delayed or lesser improvement, but with a higher rate of chronic prescription of beta-blocker therapy after 3 months, the benefit of which is well established.

Cited by 144 publications

References 22 publications

É necessário suspender o betabloqueador na insuficiência cardíaca descompensada com baixo débito?

É necessário suspender o betabloqueador na insuficiência cardíaca descompensada com baixo débito?

From laboratory to bedside: a case report of a concise and pragmatic approach on heart failure

Chronic beta blocker therapy before admission influences length of hospital stay among patients with acutely decompensated heart failure

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