Evidence map›Paper›PMID 28123760›Full record

ArticleOpen heart

Relationships among achieved heart rate, β-blocker dose and long-term outcomes in patients with heart failure with atrial fibrillation.

Robert J H Miller, Jonathan G Howlett, Michael H Chiu, Danielle A Southern, Merril Knudtson, Stephen B Wilton

Abstract read
In one paragraph

Article in Open heart. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Robert J H MillerLibin Cardiovascular Institute of Alberta, University of Calgary , Calgary, Alberta , Canada.ORCID 0000-0003-4676-2433
Jonathan G HowlettLibin Cardiovascular Institute of Alberta, University of Calgary , Calgary, Alberta , Canada.
Michael H ChiuLibin Cardiovascular Institute of Alberta, University of Calgary , Calgary, Alberta , Canada.
Danielle A SouthernDepartment of Community Health Sciences , Calgary Institute for Population and Public Health, University of Calgary , Calgary, Alberta , Canada.
Merril KnudtsonLibin Cardiovascular Institute of Alberta, University of Calgary , Calgary, Alberta , Canada.
Stephen B WiltonLibin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, Calgary Institute for Population and Public Health, University of Calgary, Calgary, Alberta, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveHigher β-blocker dose and lower heart rate are associated with decreased mortality in patients with systolic heart failure (HF) and sinus rhythm. However, in the 30% of patients with HF with atrial fibrillation (AF), whether β-blocker dose or heart rate predict mortality is less clear. We assessed the association between β-blocker dose, heart rate and all-cause mortality in patients with HF and AF.

methodsWe performed a retrospective cohort study in 935 patients (60% men, mean age 74, 44.7% with reduced left ventricular ejection fraction (LVEF)) discharged with concurrent diagnoses of HF and AF. We used Cox models to test independent associations between higher versus lower predischarge heart rate (dichotomised at 70/min) and higher versus lower β-blocker dose (dichotomised at 50% of the evidence-based target), with the primary composite end point of mortality or cardiovascular rehospitalisation over a median of 2.9 years. All analyses were stratified by the presence of left ventricular systolic dysfunction (LVEF≤40%).

resultsAfter adjustment for covariates, neither β-blocker dose nor predischarge heart rate was associated with the primary composite end point. However, tachycardia at admission (heart rate >120/min) was associated with a reduced risk of the composite outcome in patients with both reduced LVEF (adjusted HR 0.67, 95% CI 0.52 to 0.88, p<0.01) and preserved LVEF (adjusted HR 0.79, 95% CI 0.64 to 0.98, p=0.04).

conclusionsWe found no associations between predischarge heart rate or β-blocker dosage and clinical outcomes in patients with recent hospitalisations for HF and AF.

Indexed as

HEART FAILURE

Identifiers

PMID28123760
PMCPMC5237748

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.