PMID- 28737066
OWN - NLM
STAT- MEDLINE
DCOM- 20180813
LR  - 20180813
IS  - 1531-1937 (Electronic)
IS  - 0897-1900 (Linking)
VI  - 31
IP  - 1
DP  - 2018 Feb
TI  - beta-Blockade in Heart Failure With Reduced Ejection Fraction: Does Heart Rate 
      Control Influence Readmissions?
PG  - 40-45
LID - 10.1177/0897190017696951 [doi]
AB  - BACKGROUND: Raised resting heart rate (HR), >70 beats per minute (bpm), has been 
      shown to be a risk factor for adverse cardiovascular outcomes and hospital 
      readmissions, specifically in patients with heart failure with reduced ejection 
      fraction (HF rEF). Given their mortality benefit, beta-blockers are recommended in 
      HF rEF, with a goal to titrate to a maximum tolerated dose rather than a specific 
      HR target. OBJECTIVE: To determine the impact of optimal HR control achievement 
      prior to hospital discharge on hospital readmissions in patients with HF rEF 
      receiving beta-blockade. METHODS: A retrospective study of patients admitted to 5 
      adult hospitals within a large urban health-care system, between 2013 and 2015, 
      was conducted. Patients were identified via International Classification of 
      Diseases, Ninth Revision ( ICD-9) coding for acute on chronic HF rEF. RESULTS: Of 
      the 225 patients included, 20% achieved optimal HR control (n = 46, HR <70 bpm; n 
      = 179, HR >/=70 bpm) and only 15% received beta-blocker titration during hospital 
      admission. Of note, 25% of patients receiving >/=50% target dose (n = 79) and 28% 
      receiving 100% target dose (n = 39) achieved optimal HR control. At 30 days, 
      patients with an HR <70 bpm versus HR >/=70 bpm exhibited similar readmission rates 
      (9% vs 11%, respectively; P > .99) and ED visits (11% vs 8%, respectively; P = 
      .57). CONCLUSIONS: Readmission rates were similar among patients with HF rEF 
      despite the majority failing to achieve optimal HR control from beta-blockade. 
      However, beta-blocker dosing remains suboptimal relative to guideline-recommended 
      target doses. Opportunities exist for inpatient clinicians to optimize beta-blockade 
      in an attempt to achieve HR control.
FAU - Owens, Ryan E
AU  - Owens RE
AD  - 1 Department of Pharmacy Practice, Wingate University School of Pharmacy, 
      Hendersonville, NC, USA.
FAU - Twilla, Jennifer D
AU  - Twilla JD
AD  - 2 Department of Pharmacy, Methodist University Hospital, Memphis, TN, USA.
AD  - 3 Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, 
      Memphis, TN, USA.
FAU - Self, Timothy H
AU  - Self TH
AD  - 3 Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, 
      Memphis, TN, USA.
FAU - Alshaya, Abdulrahman I
AU  - Alshaya AI
AD  - 3 Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, 
      Memphis, TN, USA.
FAU - Metra, Carlvin J
AU  - Metra CJ
AD  - 3 Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, 
      Memphis, TN, USA.
FAU - Cummings, Carolyn
AU  - Cummings C
AD  - 2 Department of Pharmacy, Methodist University Hospital, Memphis, TN, USA.
AD  - 3 Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, 
      Memphis, TN, USA.
FAU - Oliphant, Carrie S
AU  - Oliphant CS
AD  - 2 Department of Pharmacy, Methodist University Hospital, Memphis, TN, USA.
AD  - 3 Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, 
      Memphis, TN, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20170310
PL  - United States
TA  - J Pharm Pract
JT  - Journal of pharmacy practice
JID - 8900945
RN  - 0 (Adrenergic beta-Antagonists)
SB  - IM
MH  - Adrenergic beta-Antagonists/pharmacology/*therapeutic use
MH  - Adult
MH  - Aged
MH  - Female
MH  - Heart Failure/diagnosis/*drug therapy/*physiopathology
MH  - Heart Rate/drug effects/*physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Readmission/*trends
MH  - Retrospective Studies
MH  - Stroke Volume/drug effects/*physiology
MH  - Treatment Outcome
OTO - NOTNLM
OT  - HFrEF
OT  - heart failure
OT  - heart rate
OT  - readmission
OT  - beta-blocker
EDAT- 2017/07/25 06:00
MHDA- 2018/08/14 06:00
CRDT- 2017/07/25 06:00
PHST- 2017/07/25 06:00 [pubmed]
PHST- 2018/08/14 06:00 [medline]
PHST- 2017/07/25 06:00 [entrez]
AID - 10.1177/0897190017696951 [doi]
PST - ppublish
SO  - J Pharm Pract. 2018 Feb;31(1):40-45. doi: 10.1177/0897190017696951. Epub 2017 Mar 
      10.