title: Beta-Blockers are Associated with Decreased In-Hospital Mortality and Stroke in Acute Decompensated Heart Failure: Findings from a Retrospective Analysis of a 22-Year Registry in the Middle East (1991-2013).
abstract: Beta-blockers reduce mortality in chronic heart failure.
  
  
  
  To study intra-hospital mortality and adverse cardiovascular (CV) outcomes in relation to beta-blockade therapy in acute decompensated heart failure.
  
  
  
  We retrospectively analyzed a 22-year registry of acute decompensated heart failure (ADHF) in the Middle East.
  
  
  
  Out of the total 8066 patients admitted for ADHF, 1242(15.4%) were on beta-blockers on admission. Among those, beta-blockers were discontinued in 26.5%. Despite the existence of less CV comorbidities in patients not treated by beta-blockers, in-hospital mortality and stroke/transient ischemic attacks rates were higher in those patients compared with patients on beta-blockers on admission (14.4 vs. 3.6%, p=0.001, 0.6 vs. 0.1%, p=0.02; respectively). Additionally, continuation of beta-blockers during acute decompensation was associated with less mortality risk (p=0.001). The use of beta-blockers on admission and discharge increased significantly with time whereas in-hospital mortality decreased (p=0.001). Nevertheless, admission year was not a predictor of reduced mortality in patients treated with beta-blockers on admission (OR 0.93, 95% CI [0.56-1.54], p=0.77).
  
  
  
  Previous beta-blockade therapy in patients presenting with ADHF decreases intra-hospital mortality and the incidence of CV events and stroke/transient ischemic attacks. Moreover, nonwithdrawal of beta-blockers during hospitalization has a favorable outcome.
authors.forename: Charbel
authors.initials: C
authors.lastname: Abi Khalil
authors.affiliation: Adult Cardiology Department. Heart Hospital, Hamad Medical Corporation, Doha, Qatar. jalsuwaidi@hamad.qa.
authors.forename: Jassim
authors.initials: J
authors.lastname: Al Suwaidi
authors.forename: Rajvir
authors.initials: R
authors.lastname: Singh
authors.forename: Nidal
authors.initials: N
authors.lastname: Asaad
authors.forename: Galal
authors.initials: G
authors.lastname: Abushahba
authors.forename: Unus
authors.initials: U
authors.lastname: Kunju
authors.forename: Awad
authors.initials: A
authors.lastname: Al Qahtani
authors.forename: Hajar A
authors.initials: HA
authors.lastname: AlBinali
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011780:Qatar; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists