Effects of carvedilol therapy in patients with heart failure with preserved ejection fraction - Results from the Croatian heart failure (CRO-HF) registry

Background and objective: According to recent guidelines, the best approach for treatment of heart failure patients with preserved ejection function is still not defined. The aim of this study was to investigate how carvedilol therapy influences the survival rate, ejection fraction and NYHA class in these patients. Patients and methods: We conducted study on heart failure patients with preserved systolic function from the Croatian heart failure registry who were hospitalized in the period between 2005 and 2010. We enrolled patients with carvedilol listed as treatment on their discharge letters and patients who had been using carvedilol for at least 4 years, while for the control group we selected patients with no beta-blockers on their discharge letters (113 vs 204 respectively). The primary outcome was the overall survival rate and the secondary outcome was the change in ejection fraction of the left ventricle and NYHA class during the study. Results: Patients in the carvedilol group had a higher overall survival rate compared to patients in the control group (chi-square = 14.1, P < 0.001). Patients in the carvedilol group in two measurements had a significantly higher ejection fraction compared to the control group (F = 148.04, P < 0.001). Also, patients in the carvedilol group showed improvement in NYHA class (chi-square = 29.768, P < 0.001). Conclusion: Long term carvedilol therapy appears to be associated with a higher overall survival rate, improvement in ejection fraction and NYHA class in heart failure patients with preserved ejection fraction. (C) 2018 Elsevier Espana, S.L.U. All rights reserved.