Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2014 Mar 5;9(3):e90555.
doi: 10.1371/journal.pone.0090555. eCollection 2014.

Effects of beta-blockers on heart failure with preserved ejection fraction: a meta-analysis

Feng Liu  1 , Yanmei Chen  1 , Xuguang Feng  1 , Zhonghua Teng  1 , Ye Yuan  1 , Jianping Bin  1
Affiliations
Meta-Analysis

Effects of beta-blockers on heart failure with preserved ejection fraction: a meta-analysis

Feng Liu et al. PLoS One. .

Abstract

Background: Effects of beta-blockers on the prognosis of the heart failure patients with preserved ejection fraction (HFpEF) remain controversial. The aim of this meta-analysis was to determine the impact of beta-blockers on mortality and hospitalization in the patients with HFpEF.

Methods: A search of MEDLINE, EMBASE, and the Cochrane Library databases from 2005 to June 2013 was conducted. Clinical studies reporting outcomes of mortality and/or hospitalization for patients with HFpEF (EF ≥ 40%), being assigned to beta-blockers treatment and non-beta-blockers control group were included.

Results: A total of 12 clinical studies (2 randomized controlled trials and 10 observational studies) involving 21,206 HFpEF patients were included for this meta-analysis. The pooled analysis demonstrated that beta-blocker exposure was associated with a 9% reduction in relative risk for all-cause mortality in patients with HFpEF (95% CI: 0.87 - 0.95; P < 0.001). Whereas, the all-cause hospitalization, HF hospitalization and composite outcomes (mortality and hospitalization) were not affected by this treatment (P=0.26, P=0.97, and P=0.88 respectively).

Conclusions: The beta-blockers treatment for the patients with HFpEF was associated with a lower risk of all-cause mortality, but not with a lower risk of hospitalization. These finding were mainly obtained from observational studies, and further investigations are needed to make an assertion.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: All authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flowchart of study search and selection in this meta-analysis.
PCSs, prospective cohort studies; RCSs, retrospective cohort studies; RCTs, randomized controlled trials;
Figure 2
Figure 2. The pooled analyses of all-cause mortality and composites outcomes in beta-blockers group versus non-beta-blockers group.
CI, confidence interval; PCS, prospective cohort study; RCS, retrospective cohort study; RCTs, randomized controlled trials; RR, relative risk.
Figure 3
Figure 3. The pooled analysis of hospitalization in beta-blockers group versus non-beta-blockers group.
A: All-cause hospitalization; B: HF hospitalization CI, confidence interval; PCS, prospective cohort study; RCS, retrospective cohort study; RCTs, randomized controlled trials; RR, relative risk.
Figure 4
Figure 4. Sensitivity analyses.
A: Leave-one-out analysis; B: Subgroup analyses. The adjusted subgroup was those studies that performed multivariate analysis to obtain Relative Risks, and the provided RRs were directly used for pooling analysis. The unadjusted subgroup group was those studies without performing multivariate analysis, and the RRs were calculated by using the primary data. CI, confidence interval; HR, hazard ratio; LVEF, left ventricular ejection fraction; PCS, prospective cohort study; RCS, retrospective cohort study; RCT, randomized controlled trial; RR, relative risk.
See this image and copyright information in PMC

References

    1. Lam CS, Donal E, Kraigher-Krainer E, Vasan RS (2011) Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur J Heart Fail 13: 18–28. - PMC - PubMed
    1. Masoudi FA, Havranek EP, Smith G, Fish RH, Steiner JF, et al. (2003) Gender, age, and heart failure with preserved left ventricular systolic function. J Am Coll Cardiol 41: 217–223. - PubMed
    1. Smith GL, Masoudi FA, Vaccarino V, Radford MJ, Krumholz HM (2003) Outcomes in heart failure patients with preserved ejection fraction: mortality, readmission, and functional decline. J Am Coll Cardiol 41: 1510–1518. - PubMed
    1. Packer M, Coats AJ, Fowler MB, Katus HA, Krum H, et al. (2001) Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med 344: 1651–1658. - PubMed
    1. Krum H, Roecker EB, Mohacsi P, Rouleau JL, Tendera M, et al. (2003) Effects of initiating carvedilol in patients with severe chronic heart failure: results from the COPERNICUS Study. JAMA 289: 712–718. - PubMed

Publication types

Substances