Author + information
- Charbel Abi Khalila,b,
- Rajvir Singha,b,
- Wafa Rasheda,b,
- Adel Khalifaa,b,
- Mohammad Zubaida,b and
- Jassim Al Suwaidia,b
Background: Beta-blockers are known to decrease long-term mortality in patients with heart failure (HF). However, their role in atrial fibrillation (AF) patients with HF is controversial. We hypothesized that beta-blockade therapy in patients presenting to the emergency room (ER) due to AF, and have history of HF, improves cardiovascular mortality and morbidity.
Methods: The Gulf Survey of Atrial Fibrillation Events (Gulf-SAFE) is a prospective, observational registry of patients presenting to the ER with AF. We studied the incidence of 12-month mortality, hospitalization for HF or AF in the subset of patients with history of HF.
Results: Among the 2043 patients who presented to ER with AF, 962 (47%) had history of HF. Among those, 144 (15%) received beta-blockers on discharge while 818 (85%) did not. Participants in both groups had similar age and prevalence of ischemic heart disease (IHD) (57±16 vs 57±15.8 years; 29.4 vs 29.3%, respectively). However, there were more males (55.9 vs 47.3%, p=0.001) and higher left ventricular ejection fraction (LVEF) (52±13 vs 50±13%, p=0.02) in patients on beta-blockers compared to no beta-blockers on discharge group. At one year, all-cause mortality and hospitalizations for HF were lower in patients receiving beta-blockers on discharge compared to the non-beta blockers group (p= 0.006, OR 0.51, 95% CI [0.31 – 0.82]; p= 0.04, OR 0.68, 95% CI [0.47 – 0.99]; respectively). Hospitalizations for AF were not affected (p=0.41, OR 1.18, 95% CI [0.8 – 1.75]). After adjustment for several risk variables, including age, gender, hypertension, smoking, dyslipidemia, LVEF, past medical history of IHD and stroke/transient ischemic attack, heart rate, left atrial size and medications at discharge, beta-blockers were independently associated with lower mortality risk (p= 0.007, OR 0.45, 95% CI [0.25 – 0.81]).
Conclusions: In this cohort of patients presenting to ER in AF and a history of HF, use of beta-blockers at discharge was independently associated with better one-year survival.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmias and Clinical EP: AF Miscellaneous and Surgical Issues
Abstract Category: 6. Arrhythmias and Clinical EP: Other
Presentation Number: 1236-075
- 2017 American College of Cardiology Foundation