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Response to beta-blockers and natriuretic peptide level in acute heart failure: analysis of data from the Korean acute heart failure registry
DC Field | Value | Language |
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dc.contributor.author | 강석민 | - |
dc.date.accessioned | 2021-05-21T17:10:57Z | - |
dc.date.available | 2021-05-21T17:10:57Z | - |
dc.date.issued | 2021-09 | - |
dc.identifier.issn | 1861-0684 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/182752 | - |
dc.description.abstract | Background: To investigate the effect of beta-blockers according to NP levels and HF phenotypes because natriuretic peptide (NP) level can be used to risk-stratify HF patients regardless of left ventricular ejection fraction (LVEF). Methods: Of 5,625 patients in the Korean acute heart failure registry, we included patients with LVEF and NP levels. HF phenotypes were defined as HF with reduced ejection fraction (HFrEF) (EF ≤ 40%), HF with midrange ejection fraction (HFmrEF) (40% < EF < 50%), and HF with preserved EF (HFpEF) (EF ≥ 50%). Patients were further stratified by NP tertiles. Primary outcome was 5-year all-cause mortality according to beta-blocker use at discharge. Results: Both B-type NP (BNP) (r = -0.279, P < 0.001) and N-terminal pro-BNP (r = -0.186, P < 0.001) levels correlated inversely with LVEF. During a median follow-up duration of 961 days, 1560 (35.3%) patients died. In HFrEF, patients taking beta-blockers showed better survival regardless of NP levels. Regarding HFmrEF, there was no mortality difference between those taking and not taking beta-blockers. In HFpEF, beta-blocker use demonstrated lower mortality in those in the 3rd NP tertile (log-rank P = 0.041) but not in those in the 1st and 2nd NP tertiles (log-rank P > 0.05). After adjusting covariates, the use of beta-blockers was associated with a 38%-reduced mortality (hazard ratio: 0.62; 95% confidence interval: 0.39-0.98; P = 0.040) in HFpEF patients in the 3rd NP tertile but not in those in 1st and 2nd tertiles. Conclusions: We confirm that the use of beta-blockers is beneficial in patients with HFrEF. Furthermore, we extend the benefits of beta-blockers to patients with HFpEF and high NP levels. Clinical trial registration: ClinicalTrial.gov identifier: NCT01389843 URL: https://clinicaltrials.gov/ct2/show/NCT01389843. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Springer | - |
dc.relation.isPartOf | CLINICAL RESEARCH IN CARDIOLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.title | Response to beta-blockers and natriuretic peptide level in acute heart failure: analysis of data from the Korean acute heart failure registry | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Chan Soon Park | - |
dc.contributor.googleauthor | Jin Joo Park | - |
dc.contributor.googleauthor | Alexandre Mebazaa | - |
dc.contributor.googleauthor | Hae-Young Lee | - |
dc.contributor.googleauthor | Kye Hun Kim | - |
dc.contributor.googleauthor | Byung-Su Yoo | - |
dc.contributor.googleauthor | Seok-Min Kang | - |
dc.contributor.googleauthor | Sang Hong Baek | - |
dc.contributor.googleauthor | Eun-Seok Jeon | - |
dc.contributor.googleauthor | Jae-Joong Kim | - |
dc.contributor.googleauthor | Myeong-Chan Cho | - |
dc.contributor.googleauthor | Shung Chull Chae | - |
dc.contributor.googleauthor | Byung-Hee Oh | - |
dc.contributor.googleauthor | Dong-Ju Choi | - |
dc.identifier.doi | 10.1007/s00392-020-01689-8 | - |
dc.contributor.localId | A00037 | - |
dc.relation.journalcode | J03070 | - |
dc.identifier.eissn | 1861-0692 | - |
dc.identifier.pmid | 32588127 | - |
dc.identifier.url | https://link.springer.com/article/10.1007/s00392-020-01689-8 | - |
dc.subject.keyword | Beta-blockers | - |
dc.subject.keyword | Heart failure | - |
dc.subject.keyword | Mortality | - |
dc.subject.keyword | Natriuretic peptide | - |
dc.contributor.alternativeName | Kang, Seok Min | - |
dc.contributor.affiliatedAuthor | 강석민 | - |
dc.citation.volume | 110 | - |
dc.citation.number | 9 | - |
dc.citation.startPage | 1392 | - |
dc.citation.endPage | 1403 | - |
dc.identifier.bibliographicCitation | CLINICAL RESEARCH IN CARDIOLOGY, Vol.110(9) : 1392-1403, 2021-09 | - |
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