Evidence map›Paper›PMID 40932340›Full record

ArticleEuropean journal of heart failure2025

Beta-blockers in patients with heart failure with reduced ejection fraction and concomitant chronic obstructive pulmonary disease: Cardiovascular and respiratory outcomes.

Benedikt N Beer, Lina Benson, Christian Basile, Benedikt Schrage, Peter Moritz Becher, Stefan Blankenberg, Paulus Kirchhof, Barna Szabó-Söderberg, Marco Metra, Anne Lindberg and 8 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
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

18 authors.

Benedikt N BeerDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Lina BensonDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Christian BasileDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Benedikt SchrageDepartment of Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Peter Moritz BecherDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Stefan BlankenbergDepartment of Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Paulus KirchhofDepartment of Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Barna Szabó-SöderbergDivision of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Marco MetraCardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Anne LindbergDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Egidio ImbalzanoDepartment of Internal Medicine, University of Messina, Messina, Italy.
Giuseppe M C RosanoSan Raffaele Open University of Rome, Rome, Italy.
Patric KarlströmDepartment of Internal Medicine, Ryhov County Hospital, Region Jönköping County, Jönköping, Sweden.
Peter G M MolDepartment of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Raffaele ScorzaDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Lars H LundDivision of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Felix Lindberg *Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Gianluigi Savarese *Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0001-7732-0887

Funding

Hjärt-Lungfonden 20220680HORIZON EUROPE Framework Programme 101095479 - More-EUROPA
6 · The paper itself

Abstract

aimsPatients with heart failure (HF) with reduced ejection fraction (HFrEF) and chronic obstructive pulmonary disease (COPD) are poorly represented in HFrEF trials testing beta-blockers. We assessed cardiovascular effectiveness and respiratory safety of beta-blockers in these patients. METHODS AND

resultsPatients with HFrEF and COPD in the Swedish HF Registry (2006-2023) were included. Overlap-weighted models were used to assess associations between beta-blocker use and 5-year risk of outcomes, with cardiovascular death/total hospitalizations for HF (HHF) representing the primary cardiovascular effectiveness outcome, and total severe COPD exacerbations being the primary respiratory safety outcome. Of 5084 patients with HFrEF and COPD, median age was 75 years (interquartile range [IQR] 69-81), 68.3% were male, 36.9% were in GOLD group E, 91.5% used beta-blockers. Over a median follow-up of 2.5 years (IQR 1.0-4.8), beta-blocker users had lower crude risk of cardiovascular death/total HHF (rate ratio [RR] 0.66, 95% confidence interval [CI] 0.56-0.78) and total severe COPD exacerbations (RR 0.75, 95% CI 0.60-0.93). After overlap weighting, beta-blocker use was independently associated with lower risk of cardiovascular death/total HHF (RR 0.74, 95% CI 0.58-0.96) but not total severe COPD exacerbations (RR 0.99, 95% CI 0.73-1.35). These associations were consistent across subgroups (including GOLD groups), except for the greater magnitude of the association with lower risk of cardiovascular death/total HHF in patients with left ventricular ejection fraction <30% (p for interaction = 0.004). Falsification analyses suggested no influence from residual confounding.

conclusionsIn patients with HFrEF and COPD, beta-blocker use was associated with lower risk of cardiovascular death/total HHF, without evidence of safety concerns for COPD exacerbations.

Indexed as

Adrenergic beta-AntagonistsHeart FailurePulmonary Disease, Chronic ObstructiveRegistriesStroke VolumeAgedAged, 80 and overFemaleFollow-Up StudiesHospitalizationHumansMaleSwedenAdrenergic beta-AntagonistsBeta‐blockerChronic obstructive pulmonary diseaseEffectivenessHeart failureHFrEFSafety

Identifiers

PMID40932340
PMCPMC12803635

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Registered trials

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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.