The Impact of Treatment with Beta-Blockers upon Mortality in Chronic Heart Failure Patients.
BACKGROUND
Besides the conventional therapy for heart failure, the diuretics, cardiac glycosides and ACE-inhibitors, current pharmacotherapy includes beta-blockers, mainly because of their pathophysiological mechanisms upon heart remodeling.


OBJECTIVE
The study objective was to assess the cardiovascular mortality in the beta-blocker therapy group and to correlate it with the mortality in the control group as well as to correlate the combined outcome of death and/or hospitalization for cardiovascular reason between the two groups.


METHODS
The study included 113 chronic heart failure patients followed up for a period of 18 months. The therapy group received conventional therapy plus the target dose of beta blockers, and the control group received the conventional therapy only. The therapy group was divided in three separate subgroups in terms of the type of beta-blocker (Metoprolol subgroup, Bisoprolol and Carvedilol subgroup). To compare the mortality and the combined outcome, the RRR (relative risk reduction) and NNT (number needed to treat) were used, as well as the survival analysis by Kaplan-Meier.


RESULTS
The results showed the following: in regards of the cardiovascular mortality, the relative risk for death in the therapy group was 34%, which, though statistically not significant, is of great clinical significance. In regards of the combined outcome (death and/or number of hospitalizations) the results showed a RRR of 40% in the therapy group compared to the control group, which is statistically highly significant.


CONCLUSIONS
The study confirmed that patients with stable chronic heart failure, treated with optimal doses of beta-blockers, show a significant reduction of the risk from death as well as combined outcome (death and/or number of hospitalizations).
University Clinic of Cardiology, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
Borjanka
B
Taneva
University Clinic of Toxicology and Urgency Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
Daniela
D
Caparoska
beta-blockers; combined outcome; heart failure; mortality; relative risk reduction