β受体阻断剂治疗对患者从重度急性心力衰竭治疗中恢复的益处：来自“需要正性肌力药物支持的急性心力衰竭患者的生存率”(SPWAHFNIIS)试验的数据

Objectives:Beta-blocker therapy is recommended for most patients with chronic heart failure, although such therapy may be discontinued or reduced during hospitalizations. The aim is to determine whether β-blocker use at study entry and/or at discharge has an impact on 31- and 180-day survival. Design:Survival of Patients With Acute Heart Failure in Need of Intravenous Inotropic Support study was designed as a randomized, double-blind, active-controlled, multi-center study. Setting:Multinational. Patients:A total of 1,327 critically ill patients hospitalized with low-output heart failure in need of inotropic therapy. Intervention:Levosimendan versus dobutamine. Measurements:All-cause mortality at 31 and 180days in patients who survived initial hospitalization with/without β-blocker use at entry and/or at discharge. Results:Patients on β-blockers at entry and at discharge had significantly lower 31-day (p<.0001) and 180-day (p<.0001) mortality compared to patients without β-blockers use at both time points. The association was robust when adjusted for age and co-morbidities (p=.006 at 31days; p=.003 at 180days). Conclusions:Those results strongly suggest, in severe acutely decompensated heart failure patients, admitted on β-blockers, to continue on them at discharge.