Name:
Heart Failure, Chronic Renal Disease, and Beta Blocker Treatment
Description:
Heart Failure, Chronic Renal Disease, and Beta Blocker Treatment
Thumbnail URL:
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Duration:
T00H03M21S
Embed URL:
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Content URL:
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Upload Date:
2022-02-28T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
>> Practice Impact Extra podcasts are derived from Hurst's, The Heart Board Review, and other online resources available only through accesscardiology.com. >> Guideline treatment for heart failure reduced ejection fraction is published. But the renal status can modify treatment options. Can renal dysfunction interview with beta blocker treatment in patients with heart and reduced ejection fraction? [ Music ] Hi, Dr. Bernie here, and welcome to Practice Impact Extra.
Heart failure with reduced left ventricular ejection fraction is associated with numerous comorbidities, of which real dysfunction is both common, and its particularly important due to its impact on mortality and recommended therapy. Beta blockers are effective in improving outcomes in heart failure patients with normal renal function, yet renal impairment is often seen as a barrier in clinical practice utilizing them. A study published in JACC in 2019 sought to investigate patient prognosis and efficacy of beta blockers according to renal function.
Analysis of nearly 17,000 patients with left ventricular ejection fractions less than 50% from 10 double-blind randomized placebo-controlled trials of beta blockers versus placebo was performed. The main analysis involved 13,861 patients with heart failure, reduced ejection fraction, and sinus rhythm, and included 14% of the patients who had a GFR between 30 and 44 milliliters and 27% of patients who had a GFR between 45 and 59 milliliters per minute.
What were the results at three years? Beta blocker treatment improved survival compared to the placebo. And this outcome was substantial for all strata of patients by renal function, except for those with a GFR less than 30. Survival in that group was the same regardless of beta blocker treatment. Discontinuation due to adverse event were the same for both the beta blocker and placebo group and renal function. And renal function actually did not appear to worsen in the beta blocker group.
My perspective. Guideline-directed dosing of beta blocker therapy reduces mortality in patients with heart failure and reduced ejection fraction in both patients with moderate and moderately severe chronic renal disease. As a clinician, this study highlights the importance and value of beta blocker therapy consideration in the treatment of heart failure with reduced ejection fraction and impaired renal function. Thank you for joining me and see you next time on Practice Impact Extra.
>> We hope you enjoyed this podcast from McGraw-Hill. Subscribers to AccessCardiology have instant access to over 25,000 pages of rich medical content, receive medical updates from trusted experts, and have access to other special features. To subscribe or learn more, please visit accesscardiology.com.
