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Research snapshot: Effects of beta-blocker withdrawal in acute decompensated heart failure

Responsible for approximately 1 million hospitalizations each year, acute decompensated heart failure (ADHF), poses a challenge for health care professionals. To combat high mortality rates, patients with heart failure are often treated with beta-blockers, medications that can prevent further weakening of the heart.

A recent study in the Journal of the American College of Cardiology-Heart Failure from the University of Minnesota Medical School found the discontinuation of beta-blockers in ADHF patients was associated with a significant increase in mortality and rehospitalization.

ADHF occurs when patients with heart failure require admission to the hospital after retaining too much fluid. When the heart fails, the fluid inside of the body does not sufficiently circulate throughout organs, causing the congestion.

Beta-blockers are used in patients with heart failure to protect the heart by preventing excessive stimulation says Kurt Prins, M.D., Ph.D., lead author of the study. Due to the concerns of beta-blockers on blood flow, some physicians choose to discontinue the medication when patients are hospitalized.

“We were inspired to investigate this question because patients with ADHF continue to have poor outcomes despite intensive research,” said Prins. “We wanted to investigate the role of beta-blockers in this population because their use is often debated. We hoped to provide a more definitive answer to help guide physician treatment choices going forward.”

The study was a collaborative project between physicians and statisticians, examining three outcomes of stopping the beta-blockers: in-hospital mortality, short-term mortality and combined short-term mortality and rehospitalization. Although it is unknown how beta-blocker withdrawal directly causes harm to the heart, all three endpoints were associated with worse outcomes when beta-blockers were stopped.

“The implications for our study are patients with ADHF should have their beta-blocker continued if possible because it may reduce the risk of adverse events,” said Prins. “Going forward, we hope more physicians will continue beta-blockers in ADHF patients.”

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