caa a22 4500 605479178 CHVBK 20210128100409.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s10741-014-9453-8 doi (NATIONALLICENCE)springer-10.1007/s10741-014-9453-8 Beta-blockers in heart failure with preserved ejection fraction: a meta-analysis [Elektronische Daten] [Chirag Bavishi, Saurav Chatterjee, Sameer Ather, Dipen Patel, Franz Messerli] Beta-blockers are established drugs in heart failure with reduced ejection fraction, but their role in heart failure with preserved ejection fraction (HFpEF) is not established. Hence, we undertook a meta-analysis to evaluate the efficacy of beta-blockers on mortality and morbidity in HFpEF patients. A systematic search using PubMed, Embase, Scopus and Cochrane databases was performed to identify all relevant studies on beta-blockers and HFpEF. A random-effects model was performed to assess the role of beta-blockers on all-cause mortality and HF hospitalization. Overall 15 observational studies and two randomized control trial involving a total of 27,099 patients were included in the analysis. In the observational studies, beta-blocker therapy was associated with lower all-cause mortality [RR 0.81 (0.72-0.90), p<0.001], but not HF hospitalization [RR 0.79 (0.57-1.10), p<0.001]. However, in the two RCTs, the use of beta-blocker was not associated with all-cause mortality [RR 0.94 (0.67-1.32), p=0.72] or HF hospitalization [0.90 (0.54-1.49), p=0.68]. The results were consistent by geographic region (USA vs. rest of world) and ejection fraction subgroups. Subgroup analysis revealed that the beneficial survival effect of beta-blocker was limited to studies with mean age <75years. Observational studies showed a significant benefit from the use of beta-blockers for all-cause mortality, but not for HF hospitalization. Beta-blockers in the two RCTs were not associated with significant reduction in all-cause mortality or HF hospitalization; however, both the trials were not adequately powered and had high loss to follow-up rates. Further large sampled well-conducted randomized trials are warranted to confirm the effects of beta-blockers on mortality and hospitalization. Springer Science+Business Media New York, 2014 Beta-blockers nationallicence Heart failure with preserved ejection fraction nationallicence Meta-analysis nationallicence Bavishi Chirag Department of Medicine, Mount Sinai St. Luke's-Roosevelt Hospital, Icahn School of Medicine at Mount Sinai, 1000 Tenth Ave, 10019, New York, NY, USA aut Chatterjee Saurav Department of Medicine, Mount Sinai St. Luke's-Roosevelt Hospital, Icahn School of Medicine at Mount Sinai, 1000 Tenth Ave, 10019, New York, NY, USA aut Ather Sameer Division of Cardiovascular diseases, University of Alabama at Birmingham, Birmingham, AL, USA aut Patel Dipen Department of Medicine, Mount Sinai St. Luke's-Roosevelt Hospital, Icahn School of Medicine at Mount Sinai, 1000 Tenth Ave, 10019, New York, NY, USA aut Messerli Franz Department of Medicine, Mount Sinai St. Luke's-Roosevelt Hospital, Icahn School of Medicine at Mount Sinai, 1000 Tenth Ave, 10019, New York, NY, USA aut Heart Failure Reviews Springer US; http://www.springer-ny.com 20/2(2015-03-01), 193-201 1382-4147 20:2<193 2015 20 10741 https://doi.org/10.1007/s10741-014-9453-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10741-014-9453-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bavishi Chirag Department of Medicine, Mount Sinai St. Luke's-Roosevelt Hospital, Icahn School of Medicine at Mount Sinai, 1000 Tenth Ave, 10019, New York, NY, USA aut NATIONALLICENCE 700 1- Chatterjee Saurav Department of Medicine, Mount Sinai St. Luke's-Roosevelt Hospital, Icahn School of Medicine at Mount Sinai, 1000 Tenth Ave, 10019, New York, NY, USA aut NATIONALLICENCE 700 1- Ather Sameer Division of Cardiovascular diseases, University of Alabama at Birmingham, Birmingham, AL, USA aut NATIONALLICENCE 700 1- Patel Dipen Department of Medicine, Mount Sinai St. Luke's-Roosevelt Hospital, Icahn School of Medicine at Mount Sinai, 1000 Tenth Ave, 10019, New York, NY, USA aut NATIONALLICENCE 700 1- Messerli Franz Department of Medicine, Mount Sinai St. Luke's-Roosevelt Hospital, Icahn School of Medicine at Mount Sinai, 1000 Tenth Ave, 10019, New York, NY, USA aut NATIONALLICENCE 773 0- Heart Failure Reviews Springer US; http://www.springer-ny.com 20/2(2015-03-01), 193-201 1382-4147 20:2<193 2015 20 10741