Evidence map›Paper›PMID 26251094›Full record

SynthesisJACC. Heart failure2015

Effects of Beta-Blocker Withdrawal in Acute Decompensated Heart Failure: A Systematic Review and Meta-Analysis.

Kurt W Prins, John M Neill, John O Tyler, Peter M Eckman, Sue Duval

Erratum issued Registry-linked trialOpen access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in JACC. Heart failure, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03549923 (Impact of Early CRRT Intervention in Patients Receiving VA-ECMO Support on 30-day Mortality), which is not on this map. Cited by 73 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
73citing papers in PubMed, 5 pooled it
8.9field-weighted citation impact, top 2% 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.

NCT03549923 phase4completednot on this mapstarted 2018, after this paper: background citation

Impact of Early CRRT Intervention in Patients Receiving VA-ECMO Support on 30-day Mortality: A Randomized Controlled Trial

TypeinterventionalSponsorBeijing Anzhen HospitalRan2018 to 2023Enrolled131ConditionsCardiogenic ShockArmsSimultaneous CRRT, Conventional-indication CRRT, Esmolol, Standard care
3 · Its place in the literature

Who cites it

73 citing papers in PubMed, 5 syntheses or guidelines pooled it, 178 citations in OpenAlex.

  1. Pooled it
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  6. Trial
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  8. Article
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  13. Revisiting perioperative beta blockade: for what it's worth.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025
    Article
  14. Review
  15. Article
  16. Ventricular arrhythmias in acute heart failure: a clinical consensus statement of the Association for Acute CardioVascular Care, the European Heart Rhythm Association, and the Heart Failure Association of the European Society of Cardiology.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Article
  17. Review
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  19. Review
  20. Drug repurposing for cancer therapy.Signal transduction and targeted therapy · 2024
    Review

13 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Kurt W PrinsCardiovascular Division, University of Minnesota Medical School, Minneapolis, Minnesota. Electronic address: prin0088@umn.edu.
John M NeillDepartment of Internal Medicine, University of Alabama-Birmingham, Birmingham, Alabama.
John O TylerDepartment of Internal Medicine, University of Alabama-Birmingham, Birmingham, Alabama.
Peter M EckmanCardiovascular Division, University of Minnesota Medical School, Minneapolis, Minnesota.
Sue DuvalCardiovascular Division, University of Minnesota Medical School, Minneapolis, Minnesota.
University of Minnesota Medical Center · USUniversity of Alabama at Birmingham · US

Funding

Multidisciplinary Training in Cardiovascular ResearchT32HL069764 · NHLBI · UNIVERSITY OF MINNESOTA TWIN CITIES · PI BACHE, ROBERT JAMES · 2003 to 2013
$2.8M
NHLBI NIH HHS T32 HL069764
6 · The paper itself

Abstract

objectivesThis study sought to evaluate the effects of beta-blocker withdrawal in acute decompensated heart failure (ADHF).

backgroundPublished reports showed trends for either no harm or increased risk of in-hospital mortality, short-term mortality, and rehospitalization rates in patients admitted for ADHF that discontinued beta-blockers; however, a comprehensive analysis has not been conducted.

methodsRelevant studies from January 2000 through January 2015 were identified in the PubMed, EMBASE, and COCHRANE electronic databases. Where appropriate data were available, weighted relative risks were estimated using random-effects meta-analysis techniques.

resultsFive observational studies and 1 randomized clinical trial (n = 2,704 patients who continued beta-blocker therapy and n = 439 patients who discontinued beta-blocker therapy) that reported the short-term effects of beta-blocker withdrawal in ADHF were included in the analyses. In 2 studies, beta-blocker withdrawal significantly increased risk of in-hospital mortality (risk ratio: 3.72; 95% confidence interval [CI]: 1.51 to 9.14). Short-term mortality (relative risk: 1.61; 95% CI: 1.04 to 2.49; 4 studies) and combined short-term rehospitalization or death (relative risk: 1.59; 95% CI: 1.03 to 2.45; 4 studies) were also significantly increased.

conclusionsDiscontinuation of beta-blockers in patients admitted with ADHF was associated with significantly increased in-hospital mortality, short-term mortality, and the combined endpoint of short-term rehospitalization or mortality. These data suggest beta-blockers should be continued in ADHF patients if their clinical picture allows.

Indexed as

Adrenergic beta-AntagonistsHeart FailureHumansObservational Studies as TopicRandomized Controlled Trials as TopicSubstance Withdrawal SyndromeSurvival RateAdrenergic beta-Antagonistsacute decompensated heart failurebeta-blockersmeta-analysis

Identifiers

PMID26251094
PMCPMC4777602
OpenAlexW1057392835

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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.