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Evaluation of β-blocker therapy for long-term outcomes in patients with low ejection fraction after cardiac surgery

BACKGROUND: Preoperative low left ventricular ejection fraction (LVEF) has been reported as an independent risk factor for in-hospital mortality. However, there were few studies evaluating the long-term mortality in these patients. We, therefore, conducted this study to investigate long-term outcome...

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Autores principales: Fan, Fu-Dong, Zhang, Hai-Tao, Pan, Tuo, Tang, Xin-Long, Wang, Dong-Jin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439680/
https://www.ncbi.nlm.nih.gov/pubmed/32819270
http://dx.doi.org/10.1186/s12872-020-01651-6
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author Fan, Fu-Dong
Zhang, Hai-Tao
Pan, Tuo
Tang, Xin-Long
Wang, Dong-Jin
author_facet Fan, Fu-Dong
Zhang, Hai-Tao
Pan, Tuo
Tang, Xin-Long
Wang, Dong-Jin
author_sort Fan, Fu-Dong
collection PubMed
description BACKGROUND: Preoperative low left ventricular ejection fraction (LVEF) has been reported as an independent risk factor for in-hospital mortality. However, there were few studies evaluating the long-term mortality in these patients. We, therefore, conducted this study to investigate long-term outcomes of surgery on patients with LVEF≤35% undergoing a broad range of cardiac procedures. METHODS: We performed a retrospective cohort study in 510 patients from January 1, 2007 to September 1, 2019. These patients were divided into survival group (n = 386) and non-survival group (n = 124). The multivariate Cox analysis was used to estimate the risk factors for survival. In Cox analysis, β-blockers were indicated to be associated with long-term mortality. To further address bias, we derived a propensity score predicting the function of β-blockers on survival, and matched 52 cases to 52 controls with similar risk profiles. RESULTS: Patients were followed for a median period of 24 months (interquartile range: 11–44 months). Multivariate Cox regression analysis indicated that the non-survival group had higher weight, higher EuroSCORE, more smoking patients, longer time of cardiopulmonary bypass (CPB), more intra-aortic balloon pump (IABP) use, and more patients who always used β-blocker (HR: 2.056, 95%CI:1.236–3.420, P = 0.005) compared with survival group. After propensity matching, the group which always used β-blocker showed higher rate of all-cause death compare with the control group (61.54% vs 80.77%, P = 0.030). CONCLUSIONS: The risk factors for long-term survival were weight, EuroSCORE, smoking, CPB, IABP, always used β-blockers in patients with LVEF≤35%. The discharge prescription of β-blocker should be cautiously administrated in those patients.
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spelling pubmed-74396802020-08-24 Evaluation of β-blocker therapy for long-term outcomes in patients with low ejection fraction after cardiac surgery Fan, Fu-Dong Zhang, Hai-Tao Pan, Tuo Tang, Xin-Long Wang, Dong-Jin BMC Cardiovasc Disord Research Article BACKGROUND: Preoperative low left ventricular ejection fraction (LVEF) has been reported as an independent risk factor for in-hospital mortality. However, there were few studies evaluating the long-term mortality in these patients. We, therefore, conducted this study to investigate long-term outcomes of surgery on patients with LVEF≤35% undergoing a broad range of cardiac procedures. METHODS: We performed a retrospective cohort study in 510 patients from January 1, 2007 to September 1, 2019. These patients were divided into survival group (n = 386) and non-survival group (n = 124). The multivariate Cox analysis was used to estimate the risk factors for survival. In Cox analysis, β-blockers were indicated to be associated with long-term mortality. To further address bias, we derived a propensity score predicting the function of β-blockers on survival, and matched 52 cases to 52 controls with similar risk profiles. RESULTS: Patients were followed for a median period of 24 months (interquartile range: 11–44 months). Multivariate Cox regression analysis indicated that the non-survival group had higher weight, higher EuroSCORE, more smoking patients, longer time of cardiopulmonary bypass (CPB), more intra-aortic balloon pump (IABP) use, and more patients who always used β-blocker (HR: 2.056, 95%CI:1.236–3.420, P = 0.005) compared with survival group. After propensity matching, the group which always used β-blocker showed higher rate of all-cause death compare with the control group (61.54% vs 80.77%, P = 0.030). CONCLUSIONS: The risk factors for long-term survival were weight, EuroSCORE, smoking, CPB, IABP, always used β-blockers in patients with LVEF≤35%. The discharge prescription of β-blocker should be cautiously administrated in those patients. BioMed Central 2020-08-20 /pmc/articles/PMC7439680/ /pubmed/32819270 http://dx.doi.org/10.1186/s12872-020-01651-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Fan, Fu-Dong
Zhang, Hai-Tao
Pan, Tuo
Tang, Xin-Long
Wang, Dong-Jin
Evaluation of β-blocker therapy for long-term outcomes in patients with low ejection fraction after cardiac surgery
title Evaluation of β-blocker therapy for long-term outcomes in patients with low ejection fraction after cardiac surgery
title_full Evaluation of β-blocker therapy for long-term outcomes in patients with low ejection fraction after cardiac surgery
title_fullStr Evaluation of β-blocker therapy for long-term outcomes in patients with low ejection fraction after cardiac surgery
title_full_unstemmed Evaluation of β-blocker therapy for long-term outcomes in patients with low ejection fraction after cardiac surgery
title_short Evaluation of β-blocker therapy for long-term outcomes in patients with low ejection fraction after cardiac surgery
title_sort evaluation of β-blocker therapy for long-term outcomes in patients with low ejection fraction after cardiac surgery
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439680/
https://www.ncbi.nlm.nih.gov/pubmed/32819270
http://dx.doi.org/10.1186/s12872-020-01651-6
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