PMID- 34549676
OWN - NLM
STAT- MEDLINE
DCOM- 20220225
LR  - 20220501
IS  - 1744-2818 (Electronic)
IS  - 1350-6129 (Linking)
VI  - 29
IP  - 1
DP  - 2022 Mar
TI  - Utilization and tolerance of beta-blockers among patients with AL amyloidosis.
PG  - 31-37
LID - 10.1080/13506129.2021.1981281 [doi]
AB  - BACKGROUND: The utilization and clinical impact of beta-blockers (BBs) in cardiac 
      amyloidosis (CA) is largely unexplored. METHODS: We conducted a retrospective, 
      single-center analysis of indications, timing of initiation, types and doses of 
      BB used, reasons to discontinue BB and association between BB tolerance and 
      outcomes in a cohort of patients with immunoglobulin light chain amyloidosis 
      (AL). RESULTS: We reviewed 236 patients with AL CA and identified 53 patients 
      taking BB (22.5%). Most patients presented in New York Heart Association Class 
      (NYHA) II or III (74.5%) and 24% presented in Mayo stage IIIB. The most frequent 
      indications for BB initiation were atrial fibrillation (AF) and coronary artery 
      disease (CAD). In most cases (59%) BB was started before the diagnosis of CA. The 
      median duration of BB treatment was 9 months (interquartile range [IQR] 3-24 
      months). Among patients receiving BB, 28 tolerated BB during follow-up whereas 25 
      patients discontinued BB. The main causes of BB discontinuation were hypotension 
      and heart failure (HF) exacerbation. Patients intolerant to BB presented with 
      more advanced NYHA class, worse performance status and lower median left 
      ventricular ejection fraction (LVEF) at baseline. At median follow-up duration of 
      17.7 months, patients who did not tolerate BB had a poor survival. CONCLUSIONS: 
      Although some patients with CA may have indications for treatment with BB, their 
      use is uncommon and those with more advanced disease tolerate BB poorly. 
      Intolerance to BB in patients with cardiac AL is an indicator of poorer outcome.
FAU - Briasoulis, Alexandros
AU  - Briasoulis A
AD  - Department of Clinical Therapeutics, National Kapodistrian University of Athens, 
      Medical School, Athens, Greece.
FAU - Stamatelopoulos, Kimon
AU  - Stamatelopoulos K
AD  - Department of Clinical Therapeutics, National Kapodistrian University of Athens, 
      Medical School, Athens, Greece.
FAU - Petropoulos, Ioannis
AU  - Petropoulos I
AD  - Department of Clinical Therapeutics, National Kapodistrian University of Athens, 
      Medical School, Athens, Greece.
FAU - Patras, Raphael
AU  - Patras R
AD  - Department of Clinical Therapeutics, National Kapodistrian University of Athens, 
      Medical School, Athens, Greece.
FAU - Theodorakakou, Foteini
AU  - Theodorakakou F
AD  - Department of Clinical Therapeutics, National Kapodistrian University of Athens, 
      Medical School, Athens, Greece.
FAU - Gavriatopoulou, Maria
AU  - Gavriatopoulou M
AUID- ORCID: 0000-0002-6244-1229
AD  - Department of Clinical Therapeutics, National Kapodistrian University of Athens, 
      Medical School, Athens, Greece.
FAU - Ntalianis, Argyrios
AU  - Ntalianis A
AD  - Department of Clinical Therapeutics, National Kapodistrian University of Athens, 
      Medical School, Athens, Greece.
FAU - Dimopoulos, Meletios-Athanasios
AU  - Dimopoulos MA
AD  - Department of Clinical Therapeutics, National Kapodistrian University of Athens, 
      Medical School, Athens, Greece.
FAU - Kastritis, Efstathios
AU  - Kastritis E
AD  - Department of Clinical Therapeutics, National Kapodistrian University of Athens, 
      Medical School, Athens, Greece.
LA  - eng
PT  - Journal Article
DEP - 20210922
PL  - England
TA  - Amyloid
JT  - Amyloid : the international journal of experimental and clinical investigation : 
      the official journal of the International Society of Amyloidosis
JID - 9433802
RN  - 0 (Adrenergic beta-Antagonists)
SB  - IM
MH  - Adrenergic beta-Antagonists/adverse effects
MH  - *Heart Failure
MH  - Humans
MH  - *Immunoglobulin Light-chain Amyloidosis/drug therapy
MH  - Retrospective Studies
MH  - Stroke Volume
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Amyloidosis
OT  - beta-blocker
OT  - cardiac involvement
OT  - heart failure
OT  - tolerance
EDAT- 2021/09/23 06:00
MHDA- 2022/02/26 06:00
CRDT- 2021/09/22 08:42
PHST- 2021/09/23 06:00 [pubmed]
PHST- 2022/02/26 06:00 [medline]
PHST- 2021/09/22 08:42 [entrez]
AID - 10.1080/13506129.2021.1981281 [doi]
PST - ppublish
SO  - Amyloid. 2022 Mar;29(1):31-37. doi: 10.1080/13506129.2021.1981281. Epub 2021 Sep 
      22.