| アブストラクト | Evidence of the effectiveness of beta-blockers in heart failure (HF) and atrial fibrillation (AF) in a contemporary cohort is controversial. This study investigated the association between the use of beta-blockers and prognosis in hospitalized HF patients with and without AF in Japan. Patients hospitalized with the first episode of acute HF were identified from the National Database of Health Insurance Claims and Specific Health Checkups of Japan between April 2014 and March 2021. Associations of beta-blocker use and prognosis were compared by propensity score matching among the AF or non-AF group. A mixed-effects survival model was used, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Among 428,650 patients discharged with HF in 4,433 hospitals, 175,174 (40.9%) were >/= 85 years old, 151,873 (35.4%) had complicated AF, and 236,457 (55.2%) were beta-blocker users. In a matched AF group, beta-blocker use was associated with a lower composite outcome of all-cause mortality or HF rehospitalization (HR [95% CI], 0.95 [0.93-0.97]). A similar result was obtained in a matched non-AF group (0.95 [0.94-0.96]). In addition, the HRs in patients aged >/= 85 years and female patients were 1.00 [0.98-1.02] and 1.01 [0.98-1.03] in the AF group and 1.03 [1.01-1.05] and 0.98 [0.97-1.00] in the non-AF group, respectively. The favorable prognostic associations of beta-blocker use were observed regardless of AF in patients across a broad spectrum of HF in a superaged society. |
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| ジャーナル名 | Clinical pharmacology and therapeutics |
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| Pubmed追加日 | 2024/11/18 |
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| 投稿者 | Nakai, Michikazu; Iwanaga, Yoshitaka; Kanaoka, Koshiro; Sumita, Yoko; Nishioka, Yuichi; Myojin, Tomoya; Okada, Katsuki; Noda, Tatsuya; Imamura, Tomoaki; Miyamoto, Yoshihiro |
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| 組織名 | Department of Medical and Health Information Management, National Cerebral and;Cardiovascular Center, Suita, Japan.;Clinical Research Support Center, University of Miyazaki Hospital, Miyazaki,;Japan.;Department of Cardiology, Sakurabashi Watanabe Advanced Healthcare Hospital,;Osaka, Japan.;Department of Public Health, Health Management and Policy, Nara Medical;University, Kashihara, Japan.;Department of Cardiovascular Medicine, Osaka University Graduate School of;Medicine, Osaka, Japan.;Department of Transformative System for Medical Information, Osaka University;Graduate School of Medicine, Suita, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39552436/ |
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