Effect of beta-blocker therapy on functional status in patients with heart failure--a meta-analysis
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Effect of beta-blocker therapy on functional status in patients with heart failure--a meta-analysis. / Abdulla, Jawdat; Køber, Lars; Christensen, Erik; Torp-Pedersen, Christian.
In: European Journal of Heart Failure, Vol. 8, No. 5, 2005, p. 522-31.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Effect of beta-blocker therapy on functional status in patients with heart failure--a meta-analysis
AU - Abdulla, Jawdat
AU - Køber, Lars
AU - Christensen, Erik
AU - Torp-Pedersen, Christian
N1 - Keywords: Adrenergic beta-Antagonists; Exercise Test; Exercise Tolerance; Heart Failure; Humans; Oxygen Consumption; Randomized Controlled Trials as Topic; Treatment Outcome
PY - 2005
Y1 - 2005
N2 - BACKGROUND: The results of randomised control trials (RCTs) evaluating the effect of beta-blockers on functional status in patients with chronic heart failure are conflicting. AIM: To perform a systematic review and meta-analysis of RCTs evaluating the effect of beta-blockers on New York Heart Association (NYHA) classification and exercise tolerance in chronic heart failure. METHODS AND RESULTS: We selected 28 RCTs evaluating beta-blocker versus placebo in addition to ACE inhibitor therapy. Combined results of 23 RCTs showed that beta-blockers improved NYHA class by at least one class with odds ratio (OR) 1.80 (1.33-2.43) p<0.0001. Meta-analysis of 10 RCTs showed a significant prolongation of exercise time by 44.19 (6.62-81.75) s p=0.021. Combining 8 RCTs evaluating the maximal peak oxygen uptake and 9 RCTs evaluating 6-min walk distance showed that beta-blockers had no significant effect compared with placebo, p=0.484, and p=0.730, respectively. Combined results of the 23 RCTs showed significant reducing effect on all cause mortality with OR=0.69 (0.59-0.82) p<0.0001. CONCLUSION: Chronic use of a beta-blocker in conjunction with ACE inhibitor therapy improves dyspnoea and prolongs exercise tolerance time, but has no significant effect on 6-min walk test or maximal oxygen uptake in patients with heart failure.
AB - BACKGROUND: The results of randomised control trials (RCTs) evaluating the effect of beta-blockers on functional status in patients with chronic heart failure are conflicting. AIM: To perform a systematic review and meta-analysis of RCTs evaluating the effect of beta-blockers on New York Heart Association (NYHA) classification and exercise tolerance in chronic heart failure. METHODS AND RESULTS: We selected 28 RCTs evaluating beta-blocker versus placebo in addition to ACE inhibitor therapy. Combined results of 23 RCTs showed that beta-blockers improved NYHA class by at least one class with odds ratio (OR) 1.80 (1.33-2.43) p<0.0001. Meta-analysis of 10 RCTs showed a significant prolongation of exercise time by 44.19 (6.62-81.75) s p=0.021. Combining 8 RCTs evaluating the maximal peak oxygen uptake and 9 RCTs evaluating 6-min walk distance showed that beta-blockers had no significant effect compared with placebo, p=0.484, and p=0.730, respectively. Combined results of the 23 RCTs showed significant reducing effect on all cause mortality with OR=0.69 (0.59-0.82) p<0.0001. CONCLUSION: Chronic use of a beta-blocker in conjunction with ACE inhibitor therapy improves dyspnoea and prolongs exercise tolerance time, but has no significant effect on 6-min walk test or maximal oxygen uptake in patients with heart failure.
U2 - 10.1016/j.ejheart.2005.10.012
DO - 10.1016/j.ejheart.2005.10.012
M3 - Journal article
C2 - 16376611
VL - 8
SP - 522
EP - 531
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1567-4215
IS - 5
ER -
ID: 17396155