Evidence map›Paper›PMID 42314582›Full record

ArticleJACC. Advances2026

Beta-Blocker Discontinuation in Acute Heart Failure: A Systematic Review and Meta-Analysis.

Nima Alaeiilkhchi, Wade Thompson, Lisa M McCarthy, William McDonald, Raha Eskandari, Yanrong Maggie Yang, Douglas M Salzwedel, Parag Goyal

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Article in JACC. Advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Nima AlaeiilkhchiFaculty of Medicine, Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, Canada.
Wade ThompsonFaculty of Medicine, Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, Canada. Electronic address: Wade.thompson@ubc.ca.
Lisa M McCarthyLeslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada; Institute for Better Health, Trillium Health Partners, Mississauga, Canada; Women's College Research Institute, Toronto, Canada; Bruyère Research Institute, Ottawa, Canada.
William McDonaldProgram for the Care and Study of the Aging Heart, Department of Medicine, Weill Cornell Medicine, New York, USA.
Raha EskandariFaculty of Medicine, Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, Canada.
Yanrong Maggie YangFaculty of Medicine, Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, Canada.
Douglas M SalzwedelFaculty of Medicine, Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, Canada.
Parag GoyalProgram for the Care and Study of the Aging Heart, Department of Medicine, Weill Cornell Medicine, New York, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhether beta-blockers should be continued during hospitalization for acute decompensated heart failure (ADHF) remains uncertain.

objectivesThe objective of the study was to conduct a systematic review on continuation vs discontinuation of beta-blockers during ADHF hospitalization (PROSPERO CRD42024557727).

methodsWe searched MEDLINE, Embase, and CENTRAL from inception to September 11, 2025. We included randomized and observational studies comparing beta-blocker discontinuation with continuation during hospitalization for ADHF and grouped studies by timing of discontinuation. We conducted meta-analysis of observational studies using generic inverse-variance random-effects models, prioritizing adjusted estimates.

resultsThirteen studies met the eligibility criteria: 1 randomized trial (n = 147) and 12 cohort studies (n = 14,654). The associated risk of in-hospital mortality was uncertain for beta-blocker discontinuation vs continuation (pooled OR: 5.20; 95% CI: 0.24-113.06; I

conclusionsAvailable evidence on beta-blocker discontinuation in ADHF is of very low certainty and findings of possible harm may reflect confounding by indication and failure to restart therapy rather than causal harm. Further high-quality randomized controlled trials and nonrandomized studies may resolve uncertainty.

Indexed as

acute decompensated heart failurebeta-blockerscontinuationdiscontinuationmortalitysystematic review

Identifiers

PMID42314582
PMCPMC13311924

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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.