Beta blockade with nebivolol in elderly heart failure patients with impaired and preserved left ventricular ejection fraction: Data From SENIORS (Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors With Heart Failure)

DJ van Veldhuisen, A Cohen-Solal, M Bohm, SD Anker, D Babalis, M Roughton, AJ Coats, PA Poole-Wilson, MD Flather, SENIORS Investigators

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324 Citations (Scopus)

Abstract

Background: Beta-blockers are established drugs in patients with HF and impaired EF, but their value in preserved EF is unclear.
Methods: We studied 2,111 patients; 1,359 (64%) had impaired (=35%) EF (mean 28.7%) and 752 (36%) had preserved (>35%) EF (mean 49.2%). The effect of nebivolol was investigated in these 2 groups, and it was compared to explore the interaction of EF with outcome. Follow-up was 21 months; the primary end point was all-cause mortality or cardiovascular hospitalizations.
Results: Patients with preserved EF were more often women (49.9% vs. 29.8%) and had less advanced HF, more hypertension, and fewer prior myocardial infarctions (all p < 0.001). During follow-up, the primary end point occurred in 465 patients (34.2%) with impaired EF and in 235 patients (31.2%) with preserved EF. The effect of nebivolol on the primary end point (hazard ratio [HR] of nebivolol vs. placebo) was 0.86 (95% confidence interval: 0.72 to 1.04) in patients with impaired EF and 0.81 (95% confidence interval: 0.63 to 1.04) in preserved EF (p = 0.720 for subgroup interaction). Effects on all secondary end points were similar between groups (HR for all-cause mortality 0.84 and 0.91, respectively), and no p value for interaction was
Original languageEnglish
Pages (from-to)2150-2158
Number of pages9
JournalJournal of the American College of Cardiology
Volume53
Issue number23
DOIs
Publication statusPublished - 9 Jun 2009

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