PT  - JOURNAL ARTICLE
AU  - Tetsuya Saito
AU  - Nobuhiro Yoshijima
AU  - Hiromu Hase
AU  - Fumiaki Yashima
AU  - Hikaru Tsuruta
AU  - Hideyuki Shimizu
AU  - Keiichi Fukuda
AU  - Toru Naganuma
AU  - Kazuki Mizutani
AU  - Motoharu Araki
AU  - Norio Tada
AU  - Futoshi Yamanaka
AU  - Shinichi Shirai
AU  - Minoru Tabata
AU  - Hiroshi Ueno
AU  - Kensuke Takagi
AU  - Akihiro Higashimori
AU  - Yusuke Watanabe
AU  - Masanori Yamamoto
AU  - Kentaro Hayashida
TI  - Impact of beta blockers on patients undergoing transcatheter aortic valve replacement: the OCEAN-TAVI registry
AID  - 10.1136/openhrt-2020-001269
DP  - 2020 Jul 01
TA  - Open Heart
PG  - e001269
VI  - 7
IP  - 2
4099  - http://openheart.bmj.com/content/7/2/e001269.short
4100  - http://openheart.bmj.com/content/7/2/e001269.full
SO  - Open Heart2020 Jul 01; 7
AB  - Objective There is paucity of data on optimal medical treatment, including use of beta blockers for patients undergoing transcatheter aortic valve replacement (TAVR). The study aimed to investigate the association of beta blockers and clinical outcomes following TAVR.Methods We examined data of 2563 patients who underwent TAVR between October 2013 and May 2017 obtained from a prospective multicentre cohort registry, the optimised catheter valvular intervention-TAVI registry. We compared the 2-year cardiovascular and non-cardiovascular mortality and in-hospital outcomes between patients with and without preprocedural beta-blocker administration by propensity score matching (PSM).Results Preprocedural beta blockers were prescribed in 867 patients (33.8%). After PSM, the incidence of in-hospital congestive heart failure was significantly lower in patients with preprocedural beta blocker (p=0.046). No differences were found in 2-year cardiovascular and non-cardiovascular mortality. In the subgroup analyses, beta-blocker administration was associated with a lower cardiovascular mortality within 2 years in patients with a history of coronary artery bypass grafting (CABG; log-rank p=0.017), presence of peripheral artery disease (PAD; log-rank p=0.003) and brain natriuretic peptide (BNP) ≥400 pg/mL (log-rank p=0.003). When stratified by postprocedural left ventricular ejection fraction (post-LVEF), beta-blocker administration was associated with a lower cardiovascular mortality among patients with post-LVEF <50% (log-rank p=0.024).Conclusions Preprocedural beta-blocker administration was not associated with 2-year cardiovascular and non-cardiovascular mortality in overall, but was associated with a lower 2-year cardiovascular mortality in patients with a history of CABG, presence of PAD, BNP ≥400 pg/mL and post-LVEF <50%. The findings must be validated using randomised trials.