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Improving the quality of life and reducing sudden cardiac death by limiting the impact of heart rhythm disturbances.
Our mission is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
The ESC Working Groups' goal is to stimulate and disseminate scientific knowledge in different fields of cardiology.
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Mr Karl Swedberg,
Mr Guillaume Jondeau,
Presenter | see Discussant report
Guillaume Jondeau, FESC (France)
List of Authors: Jondeau G, Neuder Y, Eicher JC, Jourdain P, Fauveau E, Galinier M, Jegou A, Bauer F, Trochu JN, Bouzamondo A, Tanguy ML, Lechat P, for the B-CONVINCED investigators Abstract: Whether or not beta-blocker therapy should be stopped during acutely decompensated heart failure (ADHF) is unsure. In a randomised, controlled, open label, non inferiority trial, we compared beta-blockade continuation versus discontinuation during ADHF in patients with LVEF below 40% previously receiving stable beta-blocker therapy. 169 patients were included, among which 147 were evaluable. Mean age was 72±12 years, 65% were males. After 3 days, 92.8% of patients pursuing beta-blockade improved for both dyspnea and general well being according to a physician blinded for therapy vs. 92.3% of patients stopping beta-blocker. This was the main end point and the upper limit for unilateral 95% CI for the difference (6.6%) is lower that the predefined upper limit (12.5%), indicating non-inferiority. Similar findings were obtained at 8 days and when evaluation was made by the patient. Plasma BNP at day 3, length of hospital stay, re-hospitalisation rate and death rate after 3 months were also similar. Beta-blocker therapy at 3 months was given to 90% of patients vs. 76% (p<0.05). During ADHF, continuation of beta-blocker therapy is not associated with delayed or lesser improvement, but with a higher rate of chronic prescription of beta-blocker therapy after 3 months, the benefit of which is well established.
Discussant | see Presenter abstract
B-CONVINCED. Beta-blocker CONtinuation Versus INterruption in patients with Congestive heart failure hospitalizED for a decompensation episode
This congress report accompanies a presentation given at the ESC Congress 2009. Written by the author himself/herself, this report does not necessarily reflect the opinion of the European Society of Cardiology.
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