Document Detail

Inadequate heart rate control despite widespread use of beta-blockers in outpatients with stable CAD: findings from the international prospective CLARIFY registry.
MedLine Citation:
PMID:  25042656     Owner:  NLM     Status:  Publisher    
BACKGROUND: To use CLARIFY, a prospective registry of patients with stable CAD (45 countries), to explore heart rate (HR) control and beta-blocker use.
METHODS: We analyzed the CLARIFY population according to beta-blocker use via descriptive statistics with Pearson's χ(2) test for comparisons, as well as a multivariable stepwise model.
RESULTS: Data on beta-blocker use was available for 32,914 patients, in whom HR was 68±11bpm; patients with angina, previous myocardial infarction, and heart failure had HRs of 69±12, 68±11, and 70±12bpm, respectively. 75% of these patients were receiving beta-blockers. Bisoprolol (34%), metoprolol tartrate (16%) or succinate (13%), atenolol (15%), and carvedilol (12%) were mostly used; mean dosages were 49%, 76%, 35%, 53%, and 45% of maximum doses, respectively. Patients aged <65years were more likely to receive beta-blockers than patients ≥75years (P<0.0001). Gender had no effect. Subjects with HR≤60bpm were more likely to be on beta-blockers than patients with HR≥70bpm (P<0.0001). Patients with angina, previous myocardial infarction, heart failure, and hypertension were more frequently receiving beta-blockers (all P<0.0001), and those with PAD and asthma/COPD less frequently (both P<0.0001). Beta-blocker use varied according to geographical region (from 87% to 67%).
CONCLUSIONS: Three-quarters of patients with stable CAD receive beta-blockers. Even so, HR is insufficiently controlled in many patients, despite recent guidelines for the management of CAD. There is still much room for improvement in HR control in the management of stable CAD.
Michal Tendera; Kim Fox; Roberto Ferrari; Ian Ford; Nicola Greenlaw; Hélène Abergel; Cezar Macarie; Jean-Claude Tardif; Panos Vardas; José Zamorano; P Gabriel Steg;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-5
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
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