Document Detail


Programme to improve the use of beta-blockers for heart failure in the elderly and in those with severe symptoms: results of the BRING-UP 2 Study.
MedLine Citation:
PMID:  16466962     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Beta-blockers are underused in HF patients, thus strategies to implement their use are needed.
OBJECTIVES: To improve beta-blocker use in elderly and/or patients with severe heart failure (HF) and to evaluate safety and outcome.
METHODS: Patients with symptomatic HF and age>/=70 years or left ventricular EF<25% and symptoms at rest were enrolled, including those already on beta-blocker treatment. Patients who were not receiving a beta-blocker were considered for carvedilol treatment. All patients were followed up for 1-year.
RESULTS: Of the 1518 elderly patients, 505 were already on beta-blockers, and carvedilol was newly prescribed in 419 patients. At 1-year, patients treated with carvedilol had a lower incidence of death [10.8% vs. 18.0% in already treated (adjusted RR 0.68; 95%CI 0.49-0.96) and 11.2% in newly treated patients (adjusted RR 0.68; 95%CI 0.48-0.97)]. Of the 709 patients with severe HF, 38.4% were already on beta-blockers, and carvedilol was newly prescribed in 189 patients. Patients not treated with carvedilol showed the worst clinical outcome. Total rate of discontinuation (including adverse reaction and non-compliance) was 14% and 9%, respectively, in elderly and severe patients.
CONCLUSIONS: In a real world setting, beta-blocker treatment was not associated with an increased risk of adverse events in elderly and severe HF patients.
Authors:
Cristina Opasich; Alessandro Boccanelli; Massimo Cafiero; Vincenzo Cirrincione; Donatella Del Sindaco; Andrea Di Lenarda; Silvia Di Luzio; Pompilio Faggiano; Maria Frigerio; Donata Lucci; Maurizio Porcu; Giovanni Pulignano; Marino Scherillo; Luigi Tavazzi; Aldo P Maggioni;
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-02-08
Journal Detail:
Title:  European journal of heart failure     Volume:  8     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-10-23     Completed Date:  2007-02-27     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  649-57     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Salvatore Maugeri Foundation, Pavia, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / adverse effects,  therapeutic use*
Age Factors
Aged
Carbazoles / adverse effects,  therapeutic use*
Cardiac Output, Low / drug therapy*,  physiopathology
Chronic Disease
Drug Utilization*
Female
Humans
Male
Middle Aged
Patient Compliance*
Patient Education as Topic*
Practice Guidelines as Topic
Program Development
Program Evaluation*
Propanolamines / adverse effects,  therapeutic use*
Severity of Illness Index
Stroke Volume / drug effects
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Carbazoles; 0/Propanolamines; 0K47UL67F2/carvedilol

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