Abstract
Background: The SHIFT study (Systolic Heart failure treatment with the I f inhibitor ivabradine Trial) demonstrated the importance of elevated heart rate (defined as > 70 beats per minute [bpm]) despite beta-blocker use as a treatment target in patients with heart failure with reduced ejection fraction (HFrEF). Limited data are available that describe the proportion of HFrEF patients that have an elevated heart rate despite beta-blocker therapy. Methods: We analyzed data from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) to describe discharge heart rate as a function of beta-blocker use and dose. We included adult patients with a left ventricular ejection fraction <40% and excluded those with a history of a pacemaker or cardiac resynchronization therapy. For beta-blockers, we considered the 3 evidence-based beta-blockers as well as atenolol and described the dose at discharge as a percentage of the target daily dose (categories included no beta-blocker, <25%, 25-49%, > 50%). Results: Among 14,186 patients hospitalized with acute HFrEF between January 2003 and December 2004, the median discharge heart rate was 76 bpm (25 th -75 th percentile, 68-86). Of these, 10,264 (72%) were discharged on a beta-blocker. For patients not on a beta-blocker, the median discharge heart rate was 80 bpm (70-88), compared to 77 bpm (68-87) on <25% target dose, 75 bpm (66-84) on 25-49% target dose, and 74 bpm (66-83) on > 50% target dose (P<0.001) (Figure). For patients on > 50% target dose of a beta-blocker, 1397(65%) had a heart rate > 70 bpm. Conclusion: Despite treatment with beta-blockers, a substantial proportion of HFrEF patients have an elevated heart rate at hospital discharge.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
