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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

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dc.contributor.author강석민-
dc.contributor.author강석민-
dc.contributor.author강석민-
dc.date.accessioned2021-05-21T17:10:57Z-
dc.date.available2021-05-21T17:10:57Z-
dc.date.issued2021-09-
dc.identifier.issn1861-0684-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/182752-
dc.description.abstractBackground: 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.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherSpringer-
dc.relation.isPartOfCLINICAL RESEARCH IN CARDIOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleResponse to beta-blockers and natriuretic peptide level in acute heart failure: analysis of data from the Korean acute heart failure registry-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorChan Soon Park-
dc.contributor.googleauthorJin Joo Park-
dc.contributor.googleauthorAlexandre Mebazaa-
dc.contributor.googleauthorHae-Young Lee-
dc.contributor.googleauthorKye Hun Kim-
dc.contributor.googleauthorByung-Su Yoo-
dc.contributor.googleauthorSeok-Min Kang-
dc.contributor.googleauthorSang Hong Baek-
dc.contributor.googleauthorEun-Seok Jeon-
dc.contributor.googleauthorJae-Joong Kim-
dc.contributor.googleauthorMyeong-Chan Cho-
dc.contributor.googleauthorShung Chull Chae-
dc.contributor.googleauthorByung-Hee Oh-
dc.contributor.googleauthorDong-Ju Choi-
dc.identifier.doi10.1007/s00392-020-01689-8-
dc.contributor.localIdA00037-
dc.contributor.localIdA00037-
dc.contributor.localIdA00037-
dc.relation.journalcodeJ03070-
dc.identifier.eissn1861-0692-
dc.identifier.pmid32588127-
dc.identifier.urlhttps://link.springer.com/article/10.1007/s00392-020-01689-8-
dc.subject.keywordBeta-blockers-
dc.subject.keywordHeart failure-
dc.subject.keywordMortality-
dc.subject.keywordNatriuretic peptide-
dc.contributor.alternativeNameKang, Seok Min-
dc.contributor.affiliatedAuthor강석민-
dc.contributor.affiliatedAuthor강석민-
dc.contributor.affiliatedAuthor강석민-
dc.citation.volume110-
dc.citation.number9-
dc.citation.startPage1392-
dc.citation.endPage1403-
dc.identifier.bibliographicCitationCLINICAL RESEARCH IN CARDIOLOGY, Vol.110(9) : 1392-1403, 2021-09-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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