beta-blockers
DISEASE INTERVENTION COMPARISON RESULTS
Cochrane Database Syst Rev. 2004 Oct 18;(4):CD003611 Systematic Review, Cochrane Review
IN atrial fibrillation, postoperative, cardiac surgery The Use of
several antiarrhythmics (amiodarone, sotalol, beta-blockers) and pacing
As Prevention, Primary
Is better Than
placebo
To reduce the incidence of atrial fibrillation (OR between 0.26 and 0.49) and possibly (non significant) reduces stroke and lenght of stay
Cochrane Database Syst Rev. 2005 Oct 19;(4):CD003566 Systematic Review, Cochrane Review
IN chronic obstructive pulmonary disease, stable The Use of
cardioselective beta-blockers
As Treatment, Chronic
Is equal Than
placebo
To modify respiratory function: no significant difference, at 3 months, in FEV1 or respiratory symptoms
BMJ. 2011 May 10;342:d2549. doi: 10.1136/bmj.d2549 Cohorts
IN chronic obstructive pulmonary disease, stable The Use of
cardioselective beta-blockers, given in addition to inhaled corticosteroid and long acting β agonist, with or without long acting antimuscarinic
As Treatment, Chronic
Is better Than
no beta-blockers use
To reduce all-cause mortality (22% relative reduction) and reduce hospital admissions due to respiratory disease.
Lancet. 2005 Nov 5;366(9497):1622-32 Randomized Controlled Trial, Multicenter Study
IN coronary disease, myocardial infarction, ST-segment elevation The Use of
early intravenous beta-blockers (metoprolol, up to 15 mg IV then 200 mg oral daily
As Treatment, Acute
Is equal Than
placebo
To reduce at 30 days death (7.7% VS 7.8%) or death, reinfarction, or cardiac arrest combined (9.4% with metoprolol VS 9.9% with placebo).
Lancet. 2008 Sep 6;372(9641):807-16 Randomized Controlled Trial, Multicenter Study
IN coronary disease, stable, reduced left ventricular function The Use of
ivabradine, added to beta-blockers
As Treatment, Chronic
Is equal Than
placebo
To reduce a composite outcome (cardiovascular deah, myocardial infarction or worsening heart failure) at 20 months. It improved a secondary endpoint (myocardial infarction) but not main endpoint, in one subgroup analysis (patients with heart rate > 70 bpm)
PLoS One. 2014;9(3):e90555 Meta-Analysis
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
beta-blockers
As Treatment, Chronic
Is better Than
placebo or no treatment
To reduce all-cause mortality (RR 0.91). But no sig reduction of hospitalizations
Lancet. 2010 Sep 11;376(9744):875-85 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, systolic, sinus rhythm and heart rate > 70 bpm The Use of
ivabradine, eventually on top of beta-blockers
As Treatment, Chronic
Is better Than
placebo
To reduce hospitalisations for heart failure at 2 years (16% ivabradine VS 21% placebo) and possibly deaths due to heart failure (3% ivabradine VS 5% placebo) but not cardiovascular mortality.