title: Prognosis of heart failure with preserved ejection fraction treated with β-blockers: A propensity matched study in the community.
abstract: BACKGROUND
  The effect of treatment with β-blockers on the prognosis of patients newly diagnosed with heart failure with preserved ejection fraction (HFpEF) is unknown.
  
  
  OBJECTIVE
  To analyze the relationship of commencing treatment with the β-blockers bisoprolol or carvedilol (CT-βB) with the prognosis of newly diagnosed HFpEF.
  
  
  METHODS
  Prospective study over 10years on 2704 patients with HFpEF. Main outcomes were mortality (all-cause and cardiovascular), hospitalizations for HF worsening, and visits. The independent relationship between CT-βB and the prognosis, stratifying patients for cardiovascular co-morbidity after propensity score-matching (985 patients CT-βB vs. another 985 patients non-CT-βB), was analyzed.
  
  
  RESULTS
  During a median follow-up of 1877.4days (interquartile range, 1-3651.2) 1600 died (81.2%), and 1702 were hospitalized (86.4%). CT-βB was associated with a lower risk of mortality (all-cause: HR [CI 95%] 0.78 [0.71 to 0.85], and cardiovascular: 0.75 [0.69 to 0.82]), a lower hospitalization rate (per 100 persons-year), 15.8 vs. 19.2, and a lower 30-day readmission rate (per 100 persons-year), 4.0 vs. 5.8, (P<0.001 in all cases), even after adjustment for the propensity to take β-blockers or other medications, comorbidities, and other potential confounders. These effects of CT-βB were independent of gender, and were observed in both patients taking high dose βB (over the median dose) and lower dose βB (under or equal to the median dose).
  
  
  CONCLUSIONS
  In this propensity matched study, commencing treatment with bisoprolol or carvedilol, both at high and at lower doses, is associated with an improved prognosis of patients newly diagnosed with HFpEF.
authors: Department of Medicine, Hospital Universitario Puerto Real, University of Cadiz, School of Medicine, Spain.
authors: Gema
authors: G
authors: Ruiz
authors: Department of Medicine, Hospital Universitario Puerto Real, University of Cadiz, School of Medicine, Spain.
authors: Jose L
authors: JL
authors: Andrey
authors: Department of Medicine, Hospital Universitario Puerto Real, University of Cadiz, School of Medicine, Spain.
authors: Jose L
authors: JL
authors: Puerto
authors: Department of Medicine, Hospital Universitario Puerto Real, University of Cadiz, School of Medicine, Spain.
authors: Miguel A
authors: MA
authors: Escobar
authors: Department of Medicine, Hospital Universitario Puerto Real, University of Cadiz, School of Medicine, Spain.
authors: Sotero P
authors: SP
authors: Romero
authors: Department of Medicine, Hospital Universitario Puerto Real, University of Cadiz, School of Medicine, Spain.
authors: Rocio
authors: R
authors: Aranda
authors: Department of Medicine, Hospital Universitario Puerto Real, University of Cadiz, School of Medicine, Spain.
authors: María J
authors: MJ
authors: Pedrosa
authors: Department of Medicine, Hospital Universitario Puerto Real, University of Cadiz, School of Medicine, Spain. Electronic address: francisco.gomez@uca.es.
authors: Francisco
authors: F
authors: Gomez
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D057216:Propensity Score; D011446:Prospective Studies; D012111:Residence Characteristics; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology*; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists
keywords: Adrenergic beta-antagonists; Heart failure; Preserved ejection fraction; Preserved systolic function