Beta-blockers are the cornerstone of therapy for heart failure; however, the effects of these drugs on the prognosis of patients with concomitant atrial fibrillation remain controversial.
The objective of a meta-analysis was to evaluate the efficacy of beta-blockers on mortality in heart failure coexisting with atrial fibrillation.
Observational cohort studies and randomized controlled studies reporting outcomes of mortality or heart failure hospitalizations for patients with heart failure and atrial fibrillation, being assigned to beta-blockers treatment and non-beta-blockers group were included.
A total of 8 clinical studies ( 5 randomized controlled trials and 3 observational cohort studies ) involving 34197 patients were included in the analysis.
The pooled analysis demonstrated that beta-blockers treatment was associated with a 22% reduction in relative risk of all-cause mortality in patients with heart failure and atrial fibrillation ( RR: 0.78; 95% CI 0.71-0.86; p less than 0.00001; I² = 27% ).
The pooled analysis of 5 studies reporting the outcome of heart failure hospitalization ( 2774 patients ) showed that therapy with beta-blockers was not associated with a reduction of heart failure hospitalizations ( RR: 0.94; 95% CI 0.79-1.11; p = 0.46; I² = 38% ).
In conclusion, the meta-analysis suggests the potential mortality benefit of beta-blockers in patients with heart failure and atrial fibrillation.
Researchers have concluded that it is premature to deny patients with atrial fibrillation and heart failure therapy with beta-blockers considering current evidence. ( Xagena )
Ma G, Fang Q, Wang F. Cardiol J 2018; Epub ahead of print