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Titolo:
Influence of beta-blockers on mortality in chronic heart failure
Autore:
Hart, SM;
Indirizzi:
Henry Ford Med Ctr Sterling Hts, Henry Ford Hlth Syst, Anticoagulat Clin, Sterling Hts, MI 48310 USA Henry Ford Med Ctr Sterling Hts Sterling Hts MIUSA 48310 s, MI 48310 USA
Titolo Testata:
ANNALS OF PHARMACOTHERAPY
fascicolo: 12, volume: 34, anno: 2000,
pagine: 1440 - 1451
SICI:
1060-0280(200012)34:12<1440:IOBOMI>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
LONG-TERM TREATMENT; DILATED CARDIOMYOPATHY; EJECTION FRACTION; BLOCKING-AGENTS; DOUBLE-BLIND; CARVEDILOL; METOPROLOL; BLOCKADE; PROGRESSION; ACTIVATION;
Keywords:
beta-blocking agents; bisoprolol; carvedilol; metoprolol; heart failure;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
57
Recensione:
Indirizzi per estratti:
Indirizzo: Hart, SM Henry Ford Med Ctr Sterling Hts, Henry Ford Hlth Syst, Anticoagulat Clin, 3500 15 Mile Rd, Sterling Hts, MI 48310 USA Henry Ford Med Ctr Sterling Hts 3500 15 Mile Rd Sterling Hts MI USA 48310
Citazione:
S.M. Hart, "Influence of beta-blockers on mortality in chronic heart failure", ANN PHARMAC, 34(12), 2000, pp. 1440-1451

Abstract

OBJECTIVE: To briefly discuss the pathophysiology of heart failure and therationale for the use of beta -blockers in the treatment of chronic heart failure. Key morbidity reduction trials are briefly mentioned, and recent mortality reduction trials are reviewed. General recommendations regarding the use of beta -blockers in heart failure are also included to guide clinical practice. STUDY SELECTION/DATA EXTRACTION: Randomized placebo-controlled clinical trials and meta-analyses evaluating mortality reduction with beta -blockers in the treatment of heart failure were identified using a MEDLINE search from January 1993 to March 2000. Abstracts are presented results from recent scientific meetings were also considered. DATA SYNTHESIS: beta -Blockers have been shown to decrease hospitalizationfor worsening heart failure, decrease the need for heart transplant, improve New York Heart Association (NYHA) functional class, and increase left-ventricular ejection fraction. A mortality benefit has recently been demonstrated for patients with chronic heart failure. Carvedilol, bisoprolol, and controlled-release/extended-release metoprolol decreased the risk of dying by 65%, 34%, and 34%, respectively, in patients with primarily NYHA functional class II and III and systolic dysfunction. The benefit of these agents in patients with class IV heart failure or determining whether one agent hasan advantage over another is being investigated in ongoing clinical trials. CONCLUSIONS: Several beta -blockers have demonstrated mortality reduction in the treatment of patients with NYHA functional class II or III heart failure and systolic dysfunction. beta -Blockers should be considered in thesepatients when they are clinically stable and taking the current standard therapy of a diuretic plus an angiotensin-converting enzyme inhibitor or other vasodilator agent.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/04/20 alle ore 21:03:49