Evidence map›Paper›PMID 24703206›Full record

Trial reportInternational journal of cardiology2014

Beta-blockers in older patients with heart failure and preserved ejection fraction: class, dosage, and outcomes.

Kanan Patel, Gregg C Fonarow, O James Ekundayo, Inmaculada B Aban, Meredith L Kilgore, Thomas E Love, Dalane W Kitzman, Mihai Gheorghiade, Richard M Allman, Ali Ahmed

Abstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International journal of cardiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 4 pooled it
3.6field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 56 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Heart Failure in Older Patients: An Update.Journal of clinical medicine · 2025
    Review
  6. Article
  7. Article
  8. Drug Therapy for Acute and Chronic Heart Failure with Preserved Ejection Fraction with Hypertension: A State-of-the-Art Review.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2024
    Review
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. Article
  15. Review
  16. Heart Failure With Mid-range Ejection Fraction.Current heart failure reports · 2020
    Review
  17. Article
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 8 institutions in 1 country.

Kanan PatelUniversity of California, San Francisco, CA, United States.
Gregg C FonarowUniversity of California, Los Angeles, CA, United States.
O James EkundayoMeharry Medical College, Nashville, TN, United States.
Inmaculada B AbanUniversity of Alabama at Birmingham, Birmingham, AL, United States.
Meredith L KilgoreUniversity of Alabama at Birmingham, Birmingham, AL, United States.
Thomas E LoveCase Western Reserve University, Cleveland, OH, United States.
Dalane W KitzmanWake Forest School of Medicine, Winston-Salem, NC, United States.
Mihai GheorghiadeNorthwestern University, Chicago, IL, United States.
Richard M AllmanDepartment of Veterans Affairs, Geriatrics and Extended Care Services, Washington, DC, United States.
Ali AhmedUniversity of Alabama at Birmingham, Birmingham, AL, United States; Veterans Affairs Medical Center, Birmingham, AL, United States. Electronic address: aahmed@uab.edu.
University of Alabama at Birmingham · USCase Western Reserve University · USMeharry Medical College · USNorthwestern University · USOffice of Patient Care Services · USUniversity of California, Los Angeles · USUniversity of California, San Francisco · USWake Forest University · US

Funding

Wake Forest Claude D. Pepper OAIC - RenewalP30AG021332 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI Denise Kathryn Houston · 2002 to 2026
$36.4M
UAB CENTER FOR CLINICAL AND TRANSLATIONAL SCIENCE (CCTS) UL1: BPCAUL1RR025777 · NCRR · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GUAY-WOODFORD, LISA MARIE · 2008 to 2011
$22.3M
Exercise Intolerance in Older HFPEF PatientsR01AG018915 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2001 to 2019
$5.2M
Exercise Intolerance in Elderly Diastolic Heart FailureR37AG018915 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2005 to 2013
$3.4M
Neurohormonal Blockade and Outcomes in Diastolic Heart FailureR01HL097047 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2009 to 2010
$915k
NCRR NIH HHS UL1 RR025777NHLBI NIH HHS R01 HL097047NHLBI NIH HHS R01-HL097047NIA NIH HHS P30 AG021332NIA NIH HHS R01 AG018915NIA NIH HHS R37 AG018915NIA NIH HHS R37AG18915
6 · The paper itself

Abstract

backgroundWe examined the clinical effectiveness of beta-blockers considered evidenced-based to heart failure and reduced ejection fraction (HFrEF) and their recommended target doses in older adults with HF and preserved ejection fraction (HFpEF).

methodsIn OPTIMIZE-HF (2003-2004) linked to Medicare (2003-2008), of the 10,570 older (age ≥ 65 years, mean, 81 years) adults with HFpEF (EF ≥ 40%, mean 55%), 8373 had no contraindications to beta-blocker therapy. After excluding 4614 patients receiving pre-admission beta-blockers, the remaining 3759 patients were potentially eligible for new discharge prescriptions for beta-blockers and 1454 received them. We assembled a propensity-matched cohort of 1099 pairs of patients receiving beta-blockers and no beta-blockers, balanced on 115 baseline characteristics. Evidence-based beta-blockers for HFrEF, namely, carvedilol, metoprolol succinate, and bisoprolol and their respective guideline-recommended target doses were 50, 200, and 10mg/day.

resultsDuring 6 years of follow-up, new discharge prescriptions for beta-blockers had no association with the primary composite endpoint of all-cause mortality or HF rehospitalization (hazard ratio, 1.03; 95% confidence interval {CI}, 0.94-1.13; p=0.569). This association did not vary by beta-blocker evidence class or daily dose. Hazard ratios for all-cause mortality and HF rehospitalization were 0.99 (95% CI, 0.90-1.10; p=0.897) and 1.17 (95% CI, 1.03-1.34; p=0.014), respectively. The latter association lost significance when higher EF cutoffs of ≥45%, ≥50% and ≥55% were used.

conclusionsInitiation of therapy with beta-blockers considered evidence-based for HFrEF and in target doses recommended for HFrEF had no association with the composite or individual endpoints of all-cause mortality or HF rehospitalization in HFpEF.

Indexed as

Adrenergic beta-AntagonistsAgedAged, 80 and overCohort StudiesCross-Over StudiesDose-Response Relationship, DrugFemaleFollow-Up StudiesHeart FailureHumansMaleRegistriesStroke VolumeTreatment OutcomeAdrenergic beta-AntagonistsBeta-blockersHeart failurePreserved ejection fraction

Identifiers

PMID24703206
PMCPMC4085276
OpenAlexW2135051754

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.