Guideline Adherence of β-blocker Initiating Dose and its Consequence in Hospitalized Patients With Heart Failure With Reduced Ejection Fraction

Background: We aim to investigate the guideline adherence of β-blocker (BB) initiating dose in Chinese hospitalized patients with heart failure with reduced ejection fraction (HFrEF) and whether the adherence affected the in-hospital outcomes.Methods: This was a retrospective study of patients hospi...

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Autores principales:	Yiling Zhou, Yuping Zeng, Si Wang, Nan Li, Miye Wang, Ify R. Mordi, Yan Ren, Youlian Zhou, Ye Zhu, Haoming Tian, Xin Sun, Xiaoping Chen, Zhenmei An, Chim C. Lang, Sheyu Li
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	inverse probability weighting heart failure heart failure with reduced ejection fraction hospitalization beta blocker adverse events < patient safety Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/3606d45704e14ee780f7e897a5a7dcd6
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spelling	oai:doaj.org-article:3606d45704e14ee780f7e897a5a7dcd62021-11-16T07:47:55ZGuideline Adherence of β-blocker Initiating Dose and its Consequence in Hospitalized Patients With Heart Failure With Reduced Ejection Fraction1663-981210.3389/fphar.2021.770239https://doaj.org/article/3606d45704e14ee780f7e897a5a7dcd62021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fphar.2021.770239/fullhttps://doaj.org/toc/1663-9812Background: We aim to investigate the guideline adherence of β-blocker (BB) initiating dose in Chinese hospitalized patients with heart failure with reduced ejection fraction (HFrEF) and whether the adherence affected the in-hospital outcomes.Methods: This was a retrospective study of patients hospitalized with HFrEF who had initiated BBs during their hospitalization. We defined adherence to clinical practice guidelines as initiating BB with standard dose and non-adherence to guidelines if otherwise, and examined the association between adherence to guidelines and in-hospital BB-related adverse events. Subgroup analyses based on sex, age, coronary heart disease, and hypertension were performed.Results: Among 1,104 patients with HFrEF initiating BBs during hospitalization (median length of hospitalization, 12 days), 304 (27.5%) patients received BB with non-adherent initiating dose. This non-adherence was related to a higher risk (hazard ratio [95% confidence interval]) of BB dose reduction or withdrawal (1.78 [1.42 to 2.22], P < 0.001), but not significantly associated with risks of profound bradycardia, hypotension, cardiogenic shock requiring intravenous inotropes, and severe bronchospasm requiring intravenous steroid during hospitalization.Conclusion: This study identified that over a fourth of patients had received BBs with an initiating dose that was not adherent to guidelines in Chinese hospitalized patients with HFrEF, and this non-adherence was associated with BB dose reduction or withdrawal during hospitalization.Yiling ZhouYuping ZengSi WangNan LiMiye WangIfy R. MordiYan RenYoulian ZhouYe ZhuHaoming TianXin SunXiaoping ChenZhenmei AnChim C. LangSheyu LiSheyu LiSheyu LiSheyu LiFrontiers Media S.A.articleinverse probability weightingheart failureheart failure with reduced ejection fractionhospitalizationbeta blockeradverse events < patient safetyTherapeutics. PharmacologyRM1-950ENFrontiers in Pharmacology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	inverse probability weighting heart failure heart failure with reduced ejection fraction hospitalization beta blocker adverse events < patient safety Therapeutics. Pharmacology RM1-950
spellingShingle	inverse probability weighting heart failure heart failure with reduced ejection fraction hospitalization beta blocker adverse events < patient safety Therapeutics. Pharmacology RM1-950 Yiling Zhou Yuping Zeng Si Wang Nan Li Miye Wang Ify R. Mordi Yan Ren Youlian Zhou Ye Zhu Haoming Tian Xin Sun Xiaoping Chen Zhenmei An Chim C. Lang Sheyu Li Sheyu Li Sheyu Li Sheyu Li Guideline Adherence of β-blocker Initiating Dose and its Consequence in Hospitalized Patients With Heart Failure With Reduced Ejection Fraction
description	Background: We aim to investigate the guideline adherence of β-blocker (BB) initiating dose in Chinese hospitalized patients with heart failure with reduced ejection fraction (HFrEF) and whether the adherence affected the in-hospital outcomes.Methods: This was a retrospective study of patients hospitalized with HFrEF who had initiated BBs during their hospitalization. We defined adherence to clinical practice guidelines as initiating BB with standard dose and non-adherence to guidelines if otherwise, and examined the association between adherence to guidelines and in-hospital BB-related adverse events. Subgroup analyses based on sex, age, coronary heart disease, and hypertension were performed.Results: Among 1,104 patients with HFrEF initiating BBs during hospitalization (median length of hospitalization, 12 days), 304 (27.5%) patients received BB with non-adherent initiating dose. This non-adherence was related to a higher risk (hazard ratio [95% confidence interval]) of BB dose reduction or withdrawal (1.78 [1.42 to 2.22], P < 0.001), but not significantly associated with risks of profound bradycardia, hypotension, cardiogenic shock requiring intravenous inotropes, and severe bronchospasm requiring intravenous steroid during hospitalization.Conclusion: This study identified that over a fourth of patients had received BBs with an initiating dose that was not adherent to guidelines in Chinese hospitalized patients with HFrEF, and this non-adherence was associated with BB dose reduction or withdrawal during hospitalization.
format	article
author	Yiling Zhou Yuping Zeng Si Wang Nan Li Miye Wang Ify R. Mordi Yan Ren Youlian Zhou Ye Zhu Haoming Tian Xin Sun Xiaoping Chen Zhenmei An Chim C. Lang Sheyu Li Sheyu Li Sheyu Li Sheyu Li
author_facet	Yiling Zhou Yuping Zeng Si Wang Nan Li Miye Wang Ify R. Mordi Yan Ren Youlian Zhou Ye Zhu Haoming Tian Xin Sun Xiaoping Chen Zhenmei An Chim C. Lang Sheyu Li Sheyu Li Sheyu Li Sheyu Li
author_sort	Yiling Zhou
title	Guideline Adherence of β-blocker Initiating Dose and its Consequence in Hospitalized Patients With Heart Failure With Reduced Ejection Fraction
title_short	Guideline Adherence of β-blocker Initiating Dose and its Consequence in Hospitalized Patients With Heart Failure With Reduced Ejection Fraction
title_full	Guideline Adherence of β-blocker Initiating Dose and its Consequence in Hospitalized Patients With Heart Failure With Reduced Ejection Fraction
title_fullStr	Guideline Adherence of β-blocker Initiating Dose and its Consequence in Hospitalized Patients With Heart Failure With Reduced Ejection Fraction
title_full_unstemmed	Guideline Adherence of β-blocker Initiating Dose and its Consequence in Hospitalized Patients With Heart Failure With Reduced Ejection Fraction
title_sort	guideline adherence of β-blocker initiating dose and its consequence in hospitalized patients with heart failure with reduced ejection fraction
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/3606d45704e14ee780f7e897a5a7dcd6
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Guideline Adherence of β-blocker Initiating Dose and its Consequence in Hospitalized Patients With Heart Failure With Reduced Ejection Fraction

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