Association Between Beta-Blockers and Mortality and Readmission in Older Patients with Heart Failure: an Instrumental Variable Analysis

Journal of General Internal Medicine

Lauren Gilstrap, Andrea M Austin, A James O’Malley, Barbara Gladders, Amber E Barnato, Anna Tosteson, Jonathan Skinner

Background

The demographics of heart failure are changing. The rate of growth of the “older” heart failure population, specifically those≥ 75, has outpaced that of any other age group. These older patients were underrepresented in the early beta-blocker trials. There are several reasons, including a decreased potential for mortality benefit and increased risk of side effects, why the risk/benefit tradeoff may be different in this population.

Objective

We aimed to determine the association between receipt of a beta-blocker after heart failure discharge and early mortality and readmission rates among patients with heart failure and reduced ejection fraction (HFrEF), specifically patients aged 75+.

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