Critical Care Medicine

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Critical Care Medicine:
doi: 10.1097/CCM.0b013e31820a91ed
Feature Articles

Beneficial association of β-blocker therapy on recovery from severe acute heart failure treatment: Data from the Survival of Patients With Acute Heart Failure in Need of Intravenous Inotropic Support trial*

Böhm, Michael MD; Link, Andreas MD; Cai, Danlin MD; Nieminen, Markku S. MD; Filippatos, Gerasimos S. MD; Salem, Reda MD; Solal, Alain Cohen MD; Huang, Bidan PhD; Padley, Robert J. MD; Kivikko, Matti MD; Mebazaa, Alexandre MD, PhD

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Abstract

Objectives: Beta-blocker therapy is recommended for most patients with chronic heart failure, although such therapy may be discontinued or reduced during hospitalizations. The aim is to determine whether β-blocker use at study entry and/or at discharge has an impact on 31- and 180-day survival.

Design: Survival of Patients With Acute Heart Failure in Need of Intravenous Inotropic Support study was designed as a randomized, double-blind, active-controlled, multi-center study.

Setting: Multinational.

Patients: A total of 1,327 critically ill patients hospitalized with low-output heart failure in need of inotropic therapy.

Intervention: Levosimendan versus dobutamine.

Measurements: All-cause mortality at 31 and 180 days in patients who survived initial hospitalization with/without β-blocker use at entry and/or at discharge.

Results: Patients on β-blockers at entry and at discharge had significantly lower 31-day (p < .0001) and 180-day (p < .0001) mortality compared to patients without β-blockers use at both time points. The association was robust when adjusted for age and co-morbidities (p = .006 at 31 days; p = .003 at 180 days).

Conclusions: Those results strongly suggest, in severe acutely decompensated heart failure patients, admitted on β-blockers, to continue on them at discharge.

© 2011 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins

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