000			nab a22 7a 4500
999			_c17599 _d17599
003			PC17599
005			20230721140735.0
008			230721b xxu||||| |||| 00| 0 eng d
040			_cH12O
041			_aeng
100			_93036 _aBueno Zamora, Hector José _eCardiología
245	0	0	_aBETAWIN-AHF study: effect of beta-blocker withdrawal during acute decompensation in patients with chronic heart failure. _h[artículo]
260			_bClinical research in cardiology : official journal of the German Cardiac Society, _c2016
300			_a105(12):1021-9.
500			_aFormato Vancouver: Miró Ò, Müller C, Martín Sánchez FJ, Bueno H, Mebazaa A, Herrero P et al; ICA-SEMES Research Group. BETAWIN-AHF study: effect of beta-blocker withdrawal during acute decompensation in patients with chronic heart failure. Clin Res Cardiol. 2016 Dec;105(12):1021-9.
501			_aPMID: 27379611
504			_aContiene 36 referencias
520			_aObjective: To evaluate the effects of discontinuing chronic beta-blocker (BB) treatment on short-term outcome in patients with chronic heart failure (CHF) during acute decompensation. Methods: We selected all the patients previously diagnosed with CHF and currently on BB and attended for acute heart failure (AHF) in one of the 35 Spanish emergency departments participating in the EAHFE registry. Patients were classified according to BB maintenance or withdrawal (BBM or BBW, respectively) during the episode. In-hospital mortality was the primary endpoint; and 30-day mortality, 30-day combined endpoint, and prolonged hospitalization were secondary. We used logistic regression for adjustment of results according to the differences between the BBM and BBW groups, and stratified analysis by age, sex, left ventricular ejection fraction, chronic obstructive pulmonary disease, heart rate (HR), and BB type (carvedilol/bisoprolol) was performed. Results: Among 2058 patients receiving chronic BB treatment, 1990 were analyzed: BBM 530 (27 %), BBW 1460 (73 %). Compared to BBM, BBW had a higher in-hospital mortality (5.5 vs 3.0 %; p < 0.05), 30-day mortality (8.7 vs 4.5 %; p < 0.01), and 30-day combined endpoint (29.8 vs 23.4 %; p < 0.05). Multivariate adjustment confirmed an independent direct association between BBW and in-hospital mortality (OR 1.89; 95 % CI 1.09-3.26) and 30-day mortality (OR 2.01; 95 % CI 1.28-3.15). Stratified analysis indicated no interaction by all the subgroups analyzed, except for HR (p = 0.01 for interaction), which showed a greater negative impact of BBW in patients with HR >80 bpm (OR 2.74; 95 % CI 1.13-6.63). Conclusions: In the absence of clear contraindications, BB treatment should be maintained during AHF episodes in patients already receiving BB at home.
710			_9119 _aServicio de Cardiología
856			_uhttp://pc-h12o-es.m-hdoct.a17.csinet.es/pdf/pc/1/pc17599.pdf _ySolicitar documento
942			_2ddc _cART _n0