ArticleThe Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology2024
Safety and efficacy of early beta-blocker initiation in acute heart failure and cardiogenic shock: systematic review and meta-analysis.
Article in The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Beta-blockers in acute decompensated heart failure with and without cardiogenic shock: Should we initiate, continue, or withdraw? A systematic review and meta-analysis.European journal of clinical pharmacology · 2025Pooled it
- Beta-blocker administration within 24 hours after admission to the intensive care unit and mortality in critical heart failure patients: a retrospective analysis from the MIMIC-IV database.Frontiers in pharmacology · 2025Article
- Integrated multi-omics analysis and predictive modeling of heart failure using sepsis-related gene signature.PloS one · 2025Article
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4 authors.
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Abstract
backgroundThe beta-blocker (BB) initiation in acute heart failure (AHF) patients is still controversial. Some show the benefit of BB employment in decreasing the mortality outcome. This study aims to assess the safety and efficacy of in-hospital and long-term outcomes of BB initiation in AHF hospitalized patients. We searched multiple databases examining the outcome of AHF patients who had administered BB as the therapy initiation. Primary outcomes were all-cause mortality, composite endpoint after BB initiation when hospitalized, and post-discharge all-cause mortality. The secondary outcomes were adverse events after in-hospital BB initiation, including hypotension and symptomatic bradycardia after BB initiation when hospitalization and rehospitalization.
resultsEight cohort studies with 16,639 patients suffering from AHF and cardiogenic shock, with 9923 participants allocated to the early BB group and 6,713 patients in the control group. The follow-up durations ranged from 2 to 24 months. Early BB administration significantly reduced in-hospital composite endpoints (RR: 0.42; 95% CI (0.30-0.58); p < 0.001), in-hospital all-cause mortality (RR: 0.43; 95% CI (0.31-0.61); p < 0.001), discharge mortality (RR: 0.51; 95% CI (0.41-0.63); p < 0.001), and rehospitalization (RR: 0.57; 95% CI (0.44-0.74); p < 0.001). There were no discernible differences in in-hospital BB-related adverse events between the two groups (p = 0.13). Subgroup analyses conducted on AHF patients presenting with cardiogenic shock revealed no significant differences in in-hospital composite endpoint and in-hospital mortality, and similar results were shown in the naive BB population.
conclusionsThe BB initiation in AHF patients shows advantages in efficacy and safety outcome.
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