Optimizing beta-blocker therapy in chronic heart failure: a
real-world study of patients with and without atrial
fibrillation

J 2025

Optimizing beta-blocker therapy in chronic heart failure: a real-world study of patients with and without atrial fibrillation

LÁBR, Karel; Jindřich ŠPINAR; Jiří PAŘENICA; Lenka ŠPINAROVÁ; Jan KREJČÍ et al.

Základní údaje

Originální název

Optimizing beta-blocker therapy in chronic heart failure: a real-world study of patients with and without atrial fibrillation

Autoři

Vydání

POSTGRADUATE MEDICINE, OXON, TAYLOR & FRANCIS LTD, 2025, 0032-5481

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.800 v roce 2024

Označené pro přenos do RIV

Ano

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Heart failure; atrial fibrillation; adrenergic beta-antagonists; left ventricular ejection fraction; dose-response relationship; drug; treatment outcome

Štítky

14110115, 14110211, 14110228, 14119612, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 20. 2. 2026 07:56, Mgr. Tereza Miškechová

Anotace

V originále

ObjectivesHeart failure (HF) with reduced (HFrEF) or mildly reduced ejection fraction (HFmrEF) frequently coexists with atrial fibrillation (AF), leading to worse prognosis and greater therapeutic complexity. Although beta-blockers (BBs) are a cornerstone of HF treatment, their benefit in patients with AF remains unclear.MethodsWe analyzed 1088 patients with stable chronic HF and left ventricular ejection fraction < 50% enrolled in the multicentre FAR NHL registry. Patients were stratified by the presence of AF and achieved BB dose: low ( < 25%), medium (25-49%), or high (>= 50% of target). The primary endpoint was a composite of all-cause mortality, hospitalization for acute HF, left ventricular assist device (LVAD) implantation, or heart transplantation.ResultsAF was present in 379 patients (34.5%). BBs were prescribed to 94% of patients, but only 17% achieved high-dose therapy. The event rate was higher in AF patients (28.0%) than in those without AF (20.5%, p = 0.005). High BB dose was independently associated with a lower risk of the primary endpoint (HR 0.62, 95% CI 0.48-0.80; p < 0.001), consistently across both rhythm group.ConclusionHigher BB doses were associated with improved outcomes in patients with chronic HF, regardless of AF status. These real-world data support up-titration of BBs as a key component in optimized guideline-directed therapy, even in patients with coexisting AF

Citovat

LÁBR, Karel; Jindřich ŠPINAR; Jiří PAŘENICA; Lenka ŠPINAROVÁ; Jan KREJČÍ; Filip MALEK; Petr OSTADAL; Ondřej LUDKA; Jiří JARKOVSKÝ; Klára BENEŠOVÁ; Růžena LÁBROVÁ a Monika ŠPINAROVÁ. Optimizing beta-blocker therapy in chronic heart failure: a real-world study of patients with and without atrial fibrillation. POSTGRADUATE MEDICINE. OXON: TAYLOR & FRANCIS LTD, 2025, roč. 137, č. 8, s. 867-875. ISSN 0032-5481. Dostupné z: https://doi.org/10.1080/00325481.2025.2609376.

@article{2544357,
   author = {Lábr, Karel and Špinar, Jindřich and Pařenica, Jiří and Špinarová, Lenka and Krejčí, Jan and Malek, Filip and Ostadal, Petr and Ludka, Ondřej and Jarkovský, Jiří and Benešová, Klára and Lábrová, Růžena and Špinarová, Monika},
   article_location = {OXON},
   article_number = {8},
   doi = {https://doi.org/10.1080/00325481.2025.2609376},
   keywords = {Heart failure; atrial fibrillation; adrenergic beta-antagonists; left ventricular ejection fraction; dose-response relationship; drug; treatment outcome},
   language = {eng},
   issn = {0032-5481},
   journal = {POSTGRADUATE MEDICINE},
   title = {Optimizing beta-blocker therapy in chronic heart failure: a real-world study of patients with and without atrial fibrillation},
   url = {https://www.tandfonline.com/doi/full/10.1080/00325481.2025.2609376},
   volume = {137},
   year = {2025}
}

TY  - JOUR
ID  - 2544357
AU  - Lábr, Karel - Špinar, Jindřich - Pařenica, Jiří - Špinarová, Lenka - Krejčí, Jan - Malek, Filip - Ostadal, Petr - Ludka, Ondřej - Jarkovský, Jiří - Benešová, Klára - Lábrová, Růžena - Špinarová, Monika
PY  - 2025
TI  - Optimizing beta-blocker therapy in chronic heart failure: a real-world study of patients with and without atrial fibrillation
JF  - POSTGRADUATE MEDICINE
VL  - 137
IS  - 8
SP  - 867-875
EP  - 867-875
PB  - TAYLOR & FRANCIS LTD
SN  - 00325481
KW  - Heart failure
KW  - atrial fibrillation
KW  - adrenergic beta-antagonists
KW  - left ventricular ejection fraction
KW  - dose-response relationship
KW  - drug
KW  - treatment outcome
UR  - https://www.tandfonline.com/doi/full/10.1080/00325481.2025.2609376
N2  - ObjectivesHeart failure (HF) with reduced (HFrEF) or mildly reduced ejection fraction (HFmrEF) frequently coexists with atrial fibrillation (AF), leading to worse prognosis and greater therapeutic complexity. Although beta-blockers (BBs) are a cornerstone of HF treatment, their benefit in patients with AF remains unclear.MethodsWe analyzed 1088 patients with stable chronic HF and left ventricular ejection fraction < 50% enrolled in the multicentre FAR NHL registry. Patients were stratified by the presence of AF and achieved BB dose: low ( < 25%), medium (25-49%), or high (>= 50% of target). The primary endpoint was a composite of all-cause mortality, hospitalization for acute HF, left ventricular assist device (LVAD) implantation, or heart transplantation.ResultsAF was present in 379 patients (34.5%). BBs were prescribed to 94% of patients, but only 17% achieved high-dose therapy. The event rate was higher in AF patients (28.0%) than in those without AF (20.5%, p = 0.005). High BB dose was independently associated with a lower risk of the primary endpoint (HR 0.62, 95% CI 0.48-0.80; p < 0.001), consistently across both rhythm group.ConclusionHigher BB doses were associated with improved outcomes in patients with chronic HF, regardless of AF status. These real-world data support up-titration of BBs as a key component in optimized guideline-directed therapy, even in patients with coexisting AF
ER  -

LÁBR, Karel; Jindřich ŠPINAR; Jiří PAŘENICA; Lenka ŠPINAROVÁ; Jan KREJČÍ; Filip MALEK; Petr OSTADAL; Ondřej LUDKA; Jiří JARKOVSKÝ; Klára BENEŠOVÁ; Růžena LÁBROVÁ a Monika ŠPINAROVÁ. Optimizing beta-blocker therapy in chronic heart failure: a real-world study of patients with and without atrial fibrillation. \textit{POSTGRADUATE MEDICINE}. OXON: TAYLOR \&{} FRANCIS LTD, 2025, roč.~137, č.~8, s.~867-875. ISSN~0032-5481. Dostupné z: https://doi.org/10.1080/00325481.2025.2609376.

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