Thursday, January 15, 2009

New study finds beta blockers help many elderly patients with certain type of heart failure
By Kelly Winget, DCRI Communications

In a new analysis of the OPTIMIZE-HF registry focusing on elderly patients, researchers found that patients with a certain type of heart failure who are placed on beta blockers for the first time and continue to take the medication once they leave the hospital tend to live longer and have fewer rehospitalizations. The study was led by DCRI researchers.

This was true for eldery patients with left ventricular systolic dysfunction (LVSD), but not for patients with preserved systolic function. The patients with heart failure in the latter category saw virtually no change in their mortality rate or hospital readmissions.

The study results appear in the January 13 issue of the Journal of the American College of Cardiology. The DCRI's Adrian Hernandez, MD, MHS, was the lead author.

LVSD indicates that the chamber of the heart that pumps blood out to rest of the body isn't contracting properly so other organs and tissues don't receive enough blood. The other type of heart failure, where patients have preserved systolic function, is perhaps even more common.

For the study, researchers merged Medicare data with data from the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) registry to study longterm outcomes for patients new to beta-blocker therapy.

They found that patients with LVSD who were discharged with beta blockers saw a 23 percent decrease in their one-year mortality rates and also saw a significant reduction in hospital readmissions. There were more than 7,100 patients in the registry, and all were eligible for beta blockers when they were hospitalized. Forty-nine percent of the patients were placed on beta-blocker therapy.

Based on this study and others, Dr. Hernandez said there appears to be a significant benefit to treating patients who have LVSD with beta blockers. He also noted that the findings were disappointing for patients who have heart failure with systolic function. He did say that those patients might benefit from beta-blocker therapy if they also have diabetes or high blood pressure.

Researchers said that it appears necessary to develop different ways to target and treat the different types of heart failure, as perhaps half of heart failure patients have systolic function.

Other DCRI researchers involved with the study include Bradley Hammill, MS; Christopher O'Connor, MD, FACC; Kevin Schulman, MD; and Lesley Curtis, PhD.