Evidence map›Paper›PMID 31495887›Full record

ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2020

The association of beta-blocker use with mortality in elderly patients with congestive heart failure and advanced chronic kidney disease.

Amber O Molnar, William Petrcich, Matthew A Weir, Amit X Garg, Michael Walsh, Manish M Sood

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 16% 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

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Observational
  4. Review
  5. Cardiometabolic Dysregulation and Heart Failure.Reviews in cardiovascular medicine · 2025
    Review
  6. Article
  7. Article
  8. Heart Failure in Patients with Chronic Kidney Disease.Journal of clinical medicine · 2023
    Review
  9. Article
  10. Article
  11. Article
  12. Observational
  13. Beta-blockers in heart failure patients with severe chronic kidney disease-time for a randomized controlled trial?Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2020
    Article
  14. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 1 country.

Amber O MolnarDivision of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
William PetrcichInstitute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Matthew A WeirInstitute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Amit X GargInstitute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Michael WalshDivision of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Manish M SoodInstitute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Western University · CAImpact · CAInstitute for Clinical Evaluative Sciences · CAMcMaster University · CAOttawa Hospital · CA

Funding

CIHR
6 · The paper itself

Abstract

backgroundWhether the survival benefit of β-blockers in congestive heart failure (CHF) from randomized trials extends to patients with advanced chronic kidney disease (CKD) [estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 but not receiving dialysis] is uncertain.

methodsThis was a retrospective cohort study using administrative datasets. Older adults from Ontario, Canada, with incident CHF (median age 79 years) from April 2002 to March 2014 were included. We matched new users of β-blockers to nonusers on age, sex, eGFR categories (>60, 30-60, <30), CHF diagnosis date and a high-dimensional propensity score. Using Cox proportional hazards models, we examined the association of β-blocker use versus nonuse with all-cause mortality.

resultsWe matched 5862 incident β-blocker users (eGFR >60, n = 3136; eGFR 30-60, n = 2368; eGFR <30, n = 358). There were 2361 mortality events during follow-up. β-Blocker use was associated with reduced all-cause mortality [adjusted hazard ratio (HR) 0.58, 95% confidence interval (CI) 0.54-0.64]. This result was consistent across all eGFR categories (>60: adjusted HR 0.55, 95% CI 0.49-0.62; 30-60: adjusted HR 0.63, 95% CI 0.55-0.71; <30: adjusted HR 0.55, 95% CI 0.41-0.73; interaction term, P = 0.30). The results were consistent in an intention-to-treat analysis and with β-blocker use treated as a time-varying exposure.

conclusionsβ-Blocker use is associated with reduced all-cause mortality in elderly patients with CHF and CKD, including those with an eGFR <30. Randomized trials that examine β-blockers in patients with CHF and advanced CKD are needed.

Indexed as

Glomerular Filtration RateAdrenergic beta-AntagonistsAgedFemaleHeart FailureHumansMalePrognosisRenal Insufficiency, ChronicRetrospective StudiesSurvival RateAdrenergic beta-AntagonistsCHFmortalityβ-blocker

Identifiers

PMID31495887
PMCPMC7203558
OpenAlexW2973125028

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.