Beta-blocker therapy in elderly patients with renal dysfunction and heart failure
Juan Martínez-Milla1
Marcelino Cortes Garcia2
Julia Anna Palfy3
Mikel Taibo Urquia2
Marta López Castillo2
Ana Devesa Arbiol1
Ana Lucía Rivero Monteagudo2
María Luisa Martín Mariscal4
Ines Jiménez-Varas5
Sem Briongos Figuero6
Juan Antonio Franco-Pelaéz2
Jose Tuñón7
1.Department of Cardiology,Hospital Universitario Fundación Jimenez Diaz-Quirónsalud;Centro Nacional de Investigaciones Cardiovasculares,Madrid,Spain2.Department of Cardiology,Hospital Universitario Fundación Jimenez Diaz-Quirónsalud3.Department of Cardiology,Hospital Central de Asturias4.Department of Cardiology,Hospital Universitario Ruber-Quirónsalud5.Department of Endocrinology,Hospital Clinico San Carlos6.Department of Cardiology,Hospital Universitario Infanta Leonor7.Department of Cardiology,Hospital Universitario Fundación Jimenez Diaz-Quirónsalud;Universidad Autónoma de Madrid;CIBERCV,Madrid,Spain
摘要：OBJECTIVE To assess the role of beta-blockers(BB)in patients with chronic kidney disease(CKD)aged ≥ 75 years.METHODS AND RESULTS From January 2008 to July 2014,we included 390 consecutive patients ≥ 75 years of age with ejec-tion fraction ≤ 35％and glomerular filtration rate(GFR)≤ 60 mL/min per 1.73 m2.We analyzed the relationship between treat-ment with BB and mortality or cardiovascular events.The mean age of our population was 82.6 ± 4.1 years.Mean ejection frac-tion was 27.9％± 6.5％.GFR was 60-45 mL/min per 1.73 m2 in 50.3％of patients,45-30 mL/min per 1.73 m2 in 37.4％,and＜30 mL/min per 1.73 m2 in 12.3％.At the conclusion of follow-up,67.4％of patients were receiving BB.The median follow-up was 28.04(IR:19.41-36.67)months.During the study period,211 patients(54.1％)died and 257(65.9％)had a major cardiovascular event(death or hospitalization for heart failure).BB use was significantly associated with a reduced risk of death(HR=0.51,95％CI:0.35-0.74;P＜0.001).Patients receiving BB consistently showed a reduced risk of death across the different stages of CKD:stage Ⅲa(GFR=30-45 mL/min per 1.73 m2;HR=0.47,95％Cl:0.26-0.86,P＜0.0001),stage Ⅲb(GFR 30-45 mL/min per 1.73 m2;HR=0.55,95％CI:0.26-1.06,P=0.007),and stages Ⅳ and Ⅴ(GFR＜30 mL/min per 1.73 m2;HR=0.29,95％CI:0.11-0.76;P=0.047).CONCLUSIONS The use of BB in elderly patients with HFrEF and renal impairment was associated with a better prognosis.Use of BB should be encouraged when possible.
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论文发表日期：2021-01-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 20-29 )