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Bayoumi E, Lam PH, Enders R, et al. Beta-Blocker Use and Outcomes in Nursing Home Residents with Heart Failure with Reduced Ejection Fraction. Am J Med. 2021;doi: 10.1016/j.amjmed.2021.11.004.
Bayoumi, E., Lam, P. H., Enders, R., Arundel, C., Sheriff, H. M., Brar, V., Jurgens, C. Y., Deedwania, P., Faselis, C., Allman, R. M., Fonarow, G. C., & Ahmed, A. (2021). Beta-Blocker Use and Outcomes in Nursing Home Residents with Heart Failure with Reduced Ejection Fraction. The American journal of medicine, . https://doi.org/10.1016/j.amjmed.2021.11.004
Bayoumi, Essraa, et al. "Beta-Blocker Use and Outcomes in Nursing Home Residents with Heart Failure with Reduced Ejection Fraction." The American journal of medicine vol. (2021). doi: https://doi.org/10.1016/j.amjmed.2021.11.004
Bayoumi E, Lam PH, Enders R, Arundel C, Sheriff HM, Brar V, Jurgens CY, Deedwania P, Faselis C, Allman RM, Fonarow GC, Ahmed A. Beta-Blocker Use and Outcomes in Nursing Home Residents with Heart Failure with Reduced Ejection Fraction. Am J Med. 2021 Nov 30; doi: 10.1016/j.amjmed.2021.11.004. Epub 2021 Nov 30. PMID: 34861195.
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Am J Med. 2021 Nov 30; doi: 10.1016/j.amjmed.2021.11.004. Epub 2021 Nov 30.

Beta-Blocker Use and Outcomes in Nursing Home Residents with Heart Failure with Reduced Ejection Fraction.

The American journal of medicine

Essraa Bayoumi, Phillip H Lam, Robert Enders, Cherinne Arundel, Helen M Sheriff, Vijaywant Brar, Corrine Y Jurgens, Prakash Deedwania, Charles Faselis, Richard M Allman, Gregg C Fonarow, Ali Ahmed

Affiliations

  1. Veterans Affairs Medical Center, Washington, DC; Georgetown University, Washington, DC; MedStar Washington Hospital Center, Washington, DC.
  2. University of Kansas, Kansas City, KS.
  3. Veterans Affairs Medical Center, Washington, DC; Georgetown University, Washington, DC; George Washington University, Washington, DC.
  4. Veterans Affairs Medical Center, Washington, DC; George Washington University, Washington, DC.
  5. Boston College, Chestnut Hill, MA; Stony Brook University School of Nursing, Stony Brook, NY.
  6. University of California, San Francisco, CA.
  7. Veterans Affairs Medical Center, Washington, DC; George Washington University, Washington, DC; Uniformed Services University, Washington, DC.
  8. George Washington University, Washington, DC; University of Alabama at Birmingham, Birmingham, AL.
  9. University of California, Los Angeles, CA.
  10. Veterans Affairs Medical Center, Washington, DC; Georgetown University, Washington, DC; George Washington University, Washington, DC. Electronic address: [email protected].

PMID: 34861195 DOI: 10.1016/j.amjmed.2021.11.004

Abstract

BACKGROUND: Beta-blockers improve clinical outcomes in patients with heart failure with reduced ejection fraction (HFrEF). Less is known about their role in older nursing home residents with HFrEF.

METHODS: From the combined OPTIMIZE-HF and Alabama Heart Failure Project datasets, we assembled a propensity score-matched balanced cohort of 6494 hospitalized patients ≥65 years with HFrEF (ejection fraction ≤40%). In our primary approach, hazard ratios (HR) and 95% confidence intervals (CI) for outcomes associated with discharge prescriptions for beta-blockers were estimated, examining for heterogeneity by admission from nursing homes. In our sensitivity approach, we examined these associations in a separately assembled propensity score-matched cohort of 122 patients admitted from nursing homes.

RESULTS: In the matched primary cohort of 6494 patients, HRs (95% CIs) for 12-month all-cause mortality and heart failure readmission were 0.80 (0.74-0.87) and 0.94 (0.86-1.02), respectively. Respective HRs (95% CIs) in the nursing home and non-nursing home subgroups were 0.77 (0.51-1.16) and 0.81 (0.74-0.87) for all-cause mortality (interaction p, 0.653) and 1.06 (0.53-2.12) and 0.89 (0.82-0.96) for heart failure readmission (interaction p, 0.753). In the matched sensitivity cohort of 122 patients admitted from nursing homes, HRs (95% CIs) for 12-month all-cause mortality and heart failure readmission were 0.86 (0.55-1.35) and 1.07 (0.52-2.22), respectively. Similar associations were observed for 30-day outcomes.

CONCLUSIONS: Beta-blocker use was associated with a lower risk of all-cause mortality but not of heart failure readmission in older patients with HFrEF, which were similar for patients admitted and not admitted from nursing homes.

Copyright © 2021. Published by Elsevier Inc.

Keywords: Beta-blockers; heart failure; mortality; nursing home; readmission

Conflict of interest statement

Conflict of interest None of the other authors report any conflicts of interest related to this manuscript. all authors had access to the data and a role in writing the manuscript.

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