| Title |
Initiation or maintenance of beta-blocker therapy in patients hospitalized for acute heart failure
|
|---|---|
| Published in |
International Journal of Clinical Pharmacy, April 2016
|
| DOI | 10.1007/s11096-016-0265-x |
| Pubmed ID | |
| Authors |
Luiz Carlos Passos, Márcio Galvão Oliveira, Andre Rodrigues Duraes, Thiago Moreira Trindade, Andréa Cristina Costa Barbosa |
| Abstract |
Background Beta-blockers have been recommended for patients with heart failure and reduced ejection fraction for their long-term benefits. However, the tolerance to betablockers in patients hospitalized with acute heart failure should be evaluated. Objective To estimate the proportion of patients hospitalized with acute heart failure who can tolerate these agents in clinical practice and compare the clinical outcomes of patients who can and cannot tolerate treatment with beta-blockers. Setting Two reference hospitals in cardiology. Methods Retrospective cohort study of consecutive patients hospitalized for acute heart failure between September 2008 and May 2012. Population-based sample. During the study period, 325 patients were admitted consecutively, including 194 individuals with an acute heart failure diagnosis and systolic left ventricular dysfunction and ejection fraction ≤45 %, who were candidates for the initiation or continuation of beta-blockers. Main outcome measure The percentage of patients intolerant to beta-blockers and the clinical characteristics of patients. Results On admission, 61.8 % of patients were already using beta-blockers, and 73.2 % were using beta-blockers on discharge. During hospitalization, 85 % of patients used these agents for some period. The main reasons for not using betablockers were low cardiac output syndrome (24.4 %), bradycardia (24.4 %), severe hypotension or shock (17.8 %), and chronic obstructive pulmonary disease (13.3 %). Patients who were intolerant or did not use a beta-blocker had a longer hospital stay (18.3 vs. 11.0 days; p < .001), greater use of vasoactive drugs (41.5 vs. 16.3 %; p < .001, CI 1.80-7.35), sepsis and septic shock (RR = 3.02; CI 95 % 1.59-5.75), and higher mortality rate during hospitalization (22.6 vs. 2.9 %; p < .001; CI 3.05-32.26). Conclusion Beta-blockers could be used in 73.2 % of patients hospitalized for acute heart failure. Patients who can not tolerate BB presented a higher frequency of adverse clinical outcomes including frequency of sepsis, use of vasoactive drugs, average length of hospitalization, and death. |
Mendeley readers
The data shown below were compiled from readership statistics for 37 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 37 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 8 | 22% |
| Researcher | 5 | 14% |
| Student > Ph. D. Student | 4 | 11% |
| Other | 3 | 8% |
| Student > Doctoral Student | 2 | 5% |
| Other | 6 | 16% |
| Unknown | 9 | 24% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 14 | 38% |
| Nursing and Health Professions | 5 | 14% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 8% |
| Computer Science | 2 | 5% |
| Unspecified | 1 | 3% |
| Other | 2 | 5% |
| Unknown | 10 | 27% |
Attention Score in Context
This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 July 2016.
All research outputs
#6,099,875
of 23,509,253 outputs
Outputs from International Journal of Clinical Pharmacy
#315
of 1,132 outputs
Outputs of similar age
#84,261
of 300,001 outputs
Outputs of similar age from International Journal of Clinical Pharmacy
#7
of 23 outputs
Altmetric has tracked 23,509,253 research outputs across all sources so far. This one has received more attention than most of these and is in the 73rd percentile.
So far Altmetric has tracked 1,132 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.5. This one has gotten more attention than average, scoring higher than 71% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 300,001 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 71% of its contemporaries.
We're also able to compare this research output to 23 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.