The Impact of Beta Blockers on Survival in Heart Transplant Recipients: Insights from the Zabrze HTx Registry.

Grzegorz M Kubiak,Radosław Kwieciński,Michał O Zembala,Tomasz Hrapkowicz,Andrzej Tukiendorf,Agnieszka Ciarka,Piotr Przybyłowski

doi:10.1155/2020/5190248

Abstract

Introduction The data assessing the impact of beta blocker (BB) medication on survival in patients after heart transplantation (HTx) are scarce and unequivocal; therefore, we investigated this population. Methods We retrospectively analyzed the HTx Zabrze Registry of 380 consecutive patients who survived the 30-day postoperative period. Results The percentage of patients from the entire cohort taking BBs was as follows: atenolol 24 (17%), bisoprolol 67 (49%), carvedilol 11 (8%), metoprolol 28 (20%), and nebivolol 8 (6%). The patients receiving BBs were older (56.94 ± 14.68 years vs. 52.70 ± 15.35 years, p=0.008) and experienced an onset of HTx earlier in years (11.65 ± 7.04 vs. 7.24 ± 5.78 p ≤ 0.001). They also had higher hematocrit (0.40 ± 0.05 vs. 0.39 ± 0.05, p=0.022) and red blood cells (4.63 (106/μl) ± 0.71 vs. 4.45 (106/μl) ± 0.68, p=0.015). Survival according to BB medication did not differ among the groups (p=0.655) (log-rank test). Univariate Cox proportional hazard regression analysis revealed that the following parameters were associated with unfavorable diagnosis: serum concentration of albumin (g/l) HR: 0.87, 95% CI (0.81–0.94), p=0.0004; fibrinogen (mg/dl) HR: 1.006, 95% CI (1.002–1.008), p=0.0017; and C-reactive protein (mg/l) HR: 1.014, 95% CI (1.004–1.023), p=0.0044. Conclusions The use of BBs in our cohort of patients after HTx was not associated with survival benefits.

Highlights

Heart transplantation (HTx), which is the gold standard of treatment at the end stage of heart failure, is associated with denervation of the donor’s heart
Introduction. e data assessing the impact of beta blocker (BB) medication on survival in patients after heart transplantation (HTx) are scarce and unequivocal; we investigated this population
Physiological studies have shown that the exercise capacity of a denervated heart is determined by the increase in stroke volume through the Frank–Starling mechanism, and the raised heart rate (HR) contributes only later, at the peak of exercise [3]. e older studies have indicated that the use of nonselective beta blocker (BB) during physical activity resulted in reduced exercise tolerance and capacity [3, 4]

Summary

Research Article

The Impact of Beta Blockers on Survival in Heart Transplant Recipients: Insights from the Zabrze HTx Registry. E data assessing the impact of beta blocker (BB) medication on survival in patients after heart transplantation (HTx) are scarce and unequivocal; we investigated this population. We retrospectively analyzed the HTx Zabrze Registry of 380 consecutive patients who survived the 30-day postoperative period. E percentage of patients from the entire cohort taking BBs was as follows: atenolol 24 (17%), bisoprolol 67 (49%), carvedilol 11 (8%), metoprolol 28 (20%), and nebivolol 8 (6%). E patients receiving BBs were older (56.94 ± 14.68 years vs 52.70 ± 15.35 years, p 0.008) and experienced an onset of HTx earlier in years (11.65 ± 7.04 vs 7.24 ± 5.78 p ≤ 0.001). E use of BBs in our cohort of patients after HTx was not associated with survival benefits Conclusions. e use of BBs in our cohort of patients after HTx was not associated with survival benefits

Introduction

Methods

Project Retrival

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