title: The effect of beta-blocker therapy on clinical outcome in patients with Marfan's syndrome: a meta-analysis.
abstract: OBJECTIVE
  To assess the effect of beta-blockade therapy on clinical outcome in patients with Marfan's syndrome.
  
  
  BACKGROUND
  Despite the lack of definitive evidence to support its efficacy, beta-blocker therapy is widely used prophylactically in patients with Marfan's syndrome.
  
  
  METHODS
  A meta-analysis was instituted, which included studies identified by a systematic review of MEDLINE of peer-reviewed publications and by abstracts from annual scientific meeting. Outcome measures of mortality and major morbidity were compared between patients treated and untreated with beta-blockade therapy. Data was combined according to both a fixed-effects and random-effects model. The endpoints included aortic dissection or rupture, cardiovascular surgery, or death.
  
  
  RESULTS
  Six studies were included, 5 were non-randomized follow-up studies and 1 was a prospective randomized trial (802 patients). Ninety-six of 433 patients treated with beta-blocker therapy and 74 of 369 untreated patients reached designated endpoints. Utilizing a fixed-effects model, patients treated with beta-blocker therapy were more likely to reach an endpoint (odds ratio=1.50 with 95% CI 1.05-2.16). However, by a random-effects model, the treatment effect failed to reach significance (1.54 with 95% CI 0.99-2.40).
  
  
  CONCLUSIONS
  On the basis of this meta-analysis, there is no evidence that beta-blockade therapy has clinical benefit in patients with Marfan's syndrome.
authors.affiliation: Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY 10032, United States. drg5@columbia.edu
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Gersony
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: McClaughlin
authors.forename: Zhezhen
authors.initials: Z
authors.lastname: Jin
authors.forename: Welton M
authors.initials: WM
authors.lastname: Gersony
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001013:Aorta, Thoracic / Q000187:drug effects* / Q000503:physiopathology; D002986:Clinical Trials as Topic; D006801:Humans; D008382:Marfan Syndrome / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology
chemical_list: D000319:Adrenergic beta-Antagonists