Frontiers in Pharmacology (Nov 2021)

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

  • 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

DOI
https://doi.org/10.3389/fphar.2021.770239
Journal volume & issue
Vol. 12

Abstract

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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.

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