Starting beta-blocker before discharge in patients hospitalized for heart failure incre...( directed the trial. Strategies l...),Health

"Strategies like this are extremely important as the death and disability of this group of patients continues to be alarmingly high despite the availability of life-saving therapies," O'Connor said.

Heart failure is marked by the inability of the heart muscles to pump enough oxygen and nutrients in the blood to the body's tissues. Also known as congestive heart failure, its many causes include coronary artery disease, high blood pressure, previous heart attack and valve problems.

An estimated 4.7 million Americans suffer from heart failure, with 500,000 new cases reported each year, and according to the researchers, it is the only cardiovascular disease that is rising in incidence. Once diagnosed with heart failure, about 50 percent of patients will die within five years.

For the trial, the researchers randomized 363 heart failure patients to one of two groups: one received the beta-blocker carvedilol prior to hospital discharge, while the other group could receive a beta-blocker at their physician's discretion, but it could not be started until at least two weeks after discharge, according to current standard practice. After 60 days, 91 percent of patients who were started on carvedilol prior to hospital discharge were still taking a beta-blocker, while 73 percent of physician-discretion group were taking them, a difference that was highly statistically significant.

In addition, patients initiated on carvedilol pre-discharge were closer to reaching the target beta-blocker dose at 60-days as compared to the patients in the post-discharge physician discretion arm, a finding that was also statistically significant.

"Not only was the usage rate higher, but we showed that early beta-blocker treatment was safe," Gattis said. "The patients initiated on carvedilol prior to discharge did not have a higher rate of serious adverse events including worsening heart failure, hypotension, or bradycardia as compar
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Contact: Richard Merritt
merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
18-Nov-2002