da Silva Neto Luiz Fernando Leite, de Almeida Adriano Leitao, Macedo Leticia Fonseca, do Espírito Santo Caua Leal, Brito Caio Vinicius Botelho, Borges Renato Garcia Lisboa
Biological and Health Sciences Center, Faculty of medicine, State University of Para, Belem, Brazil.
Department of Community Health, Faculty of medicine, State University of Para, Belem, Brazil.
Curr Cardiol Rev. 2025;21(1):e1573403X291307. doi: 10.2174/011573403X291307240902071924.
Acute Heart Failure (HF) is related to a significant hospital mortality rate and functional impairment in many patients. However, there is still a lack of studies that support the use of Beta-blockers (BB) in the management of decompensated HF.
This study aimed to evaluate the impact on mortality of maintaining BB in patients with decompensated HF.
A systematic review and meta-analysis was performed, using the databases PubMed, Cochrane Library, SCIELO and BVS, selecting only cohort studies and Randomized Clinical Trials (RCTs) from the last 10 years, which have been selected based on inclusion and exclusion criteria.
An 86% reduction in the risk of in-hospital death was found (RR=0.14, 95% CI: 0.10- 0.18) in patients with HF who maintained the use of BB during hospitalization. A second analysis found a 44% (RR=0.56, 95% CI: 0.47-0.66) lower chance of in-hospital death in the group that previously used BB. Regarding the analysis of mortality after hospital discharge, only studies that have evaluated the use of BB in HF with reduced ejection fraction pointed to a reduction in mortality. Furthermore, some articles have found a relationship between the reduction in readmissions and the use of post-discharge BB.
There is still no consensus regarding the use of BB in patients hospitalized with decompensated HF. In view of the limitations of the data found in the present study, the need for more RCTs that address this topic is emphasized in order to resolve this uncertainty in the management of cardiovascular patients.
急性心力衰竭（HF）与许多患者的高住院死亡率和功能损害有关。然而，仍缺乏支持在失代偿性HF管理中使用β受体阻滞剂（BB）的研究。
本研究旨在评估在失代偿性HF患者中维持使用BB对死亡率的影响。
进行了一项系统评价和荟萃分析，使用了PubMed、Cochrane图书馆、SCIELO和BVS数据库，仅选择过去10年的队列研究和随机临床试验（RCT），这些研究是根据纳入和排除标准选择的。
在住院期间维持使用BB的HF患者中，发现住院死亡风险降低了86%（RR=0.14，95%CI：0.10-0.18）。第二项分析发现，之前使用BB的组住院死亡几率降低了44%（RR=0.56，95%CI：0.47-0.66）。关于出院后死亡率的分析，只有评估在射血分数降低的HF中使用BB的研究表明死亡率有所降低。此外，一些文章发现再入院率降低与出院后使用BB之间存在关联。
对于失代偿性HF住院患者使用BB仍未达成共识。鉴于本研究中发现的数据存在局限性，强调需要更多针对该主题的RCT，以解决心血管疾病患者管理中的这一不确定性。
