Evidence map›Paper›PMID 27379611›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2016

BETAWIN-AHF study: effect of beta-blocker withdrawal during acute decompensation in patients with chronic heart failure.

Òscar Miró, Christian Müller, Francisco Javier Martín-Sánchez, Héctor Bueno, Alexander Mebazaa, Pablo Herrero, Javier Jacob, Víctor Gil, Rosa Escoda, Pere Llorens and 1 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
2.7field-weighted citation impact, top 9% 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

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Article
  6. Review
  7. Observational
  8. Review
  9. Observational
  10. Association of mineralocorticoid receptor antagonist use and in-hospital outcomes in patients with acute heart failure.Clinical research in cardiology : official journal of the German Cardiac Society · 2018
    Observational
  11. 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

11 authors at 8 institutions in 3 countries.

Òscar MiróEmergency Department, Hospital Clínic, Villarroel 170, 08036, Barcelona, Catalonia, Spain. omiro@clinic.cat.
Christian MüllerDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland.
Francisco Javier Martín-SánchezEmergency Department, Hospital Clínico San Carlos, Madrid, Spain.
Héctor BuenoUniversidad Complutense de Madrid, Madrid, Spain.
Alexander MebazaaDepartment of Anesthesiology and Critical Care Medicine, Hospital Lariboisière, Université Paris Diderot, Paris, France.
Pablo HerreroEmergency Department, Hospital Universitario Central de Asturias, Oviedo, Spain.
Javier JacobEmergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
Víctor GilEmergency Department, Hospital Clínic, Villarroel 170, 08036, Barcelona, Catalonia, Spain.
Rosa EscodaEmergency Department, Hospital Clínic, Villarroel 170, 08036, Barcelona, Catalonia, Spain.
Pere LlorensEmergency Department, Home Hospitalization and Short Stay Unit, Hospital General de Alicante, Alicante, Spain.
ICA-SEMES Research Group
Hospital Clínic de Barcelona · ESBellvitge University Hospital · ESHospital Clínico San Carlos · ESHospital General Universitario de Alicante Doctor Balmis · ESHospital Universitario Central de Asturias · ESSpanish National Centre for Cardiovascular Research · ESUniversité Paris Cité · FRUniversity Hospital of Basel · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the effects of discontinuing chronic beta-blocker (BB) treatment on short-term outcome in patients with chronic heart failure (CHF) during acute decompensation.

methodsWe selected all the patients previously diagnosed with CHF and currently on BB and attended for acute heart failure (AHF) in one of the 35 Spanish emergency departments participating in the EAHFE registry. Patients were classified according to BB maintenance or withdrawal (BBM or BBW, respectively) during the episode. In-hospital mortality was the primary endpoint; and 30-day mortality, 30-day combined endpoint, and prolonged hospitalization were secondary. We used logistic regression for adjustment of results according to the differences between the BBM and BBW groups, and stratified analysis by age, sex, left ventricular ejection fraction, chronic obstructive pulmonary disease, heart rate (HR), and BB type (carvedilol/bisoprolol) was performed.

resultsAmong 2058 patients receiving chronic BB treatment, 1990 were analyzed: BBM 530 (27 %), BBW 1460 (73 %). Compared to BBM, BBW had a higher in-hospital mortality (5.5 vs 3.0 %; p < 0.05), 30-day mortality (8.7 vs 4.5 %; p < 0.01), and 30-day combined endpoint (29.8 vs 23.4 %; p < 0.05). Multivariate adjustment confirmed an independent direct association between BBW and in-hospital mortality (OR 1.89; 95 % CI 1.09-3.26) and 30-day mortality (OR 2.01; 95 % CI 1.28-3.15). Stratified analysis indicated no interaction by all the subgroups analyzed, except for HR (p = 0.01 for interaction), which showed a greater negative impact of BBW in patients with HR >80 bpm (OR 2.74; 95 % CI 1.13-6.63).

conclusionsIn the absence of clear contraindications, BB treatment should be maintained during AHF episodes in patients already receiving BB at home.

Indexed as

Adrenergic beta-AntagonistsAgedAged, 80 and overBisoprololCarbazolesCarvedilolChi-Square DistributionChronic DiseaseDrug Administration ScheduleEmergency Service, HospitalFemaleHeart FailureHospital MortalityHumansLogistic ModelsMaleAdrenergic beta-AntagonistsBisoprololCarbazolesCarvedilolPropanolaminesAcute heart failureBeta-blockersHeart failureMortalityOutcomeReadmission

Identifiers

PMID27379611
OpenAlexW2466600349

What OpenQuestion holds

Textmetadata
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.