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JACC. Heart Failure Aug 2015This study sought to evaluate the effects of beta-blocker withdrawal in acute decompensated heart failure (ADHF). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This study sought to evaluate the effects of beta-blocker withdrawal in acute decompensated heart failure (ADHF).
BACKGROUND
Published reports showed trends for either no harm or increased risk of in-hospital mortality, short-term mortality, and rehospitalization rates in patients admitted for ADHF that discontinued beta-blockers; however, a comprehensive analysis has not been conducted.
METHODS
Relevant studies from January 2000 through January 2015 were identified in the PubMed, EMBASE, and COCHRANE electronic databases. Where appropriate data were available, weighted relative risks were estimated using random-effects meta-analysis techniques.
RESULTS
Five observational studies and 1 randomized clinical trial (n = 2,704 patients who continued beta-blocker therapy and n = 439 patients who discontinued beta-blocker therapy) that reported the short-term effects of beta-blocker withdrawal in ADHF were included in the analyses. In 2 studies, beta-blocker withdrawal significantly increased risk of in-hospital mortality (risk ratio: 3.72; 95% confidence interval [CI]: 1.51 to 9.14). Short-term mortality (relative risk: 1.61; 95% CI: 1.04 to 2.49; 4 studies) and combined short-term rehospitalization or death (relative risk: 1.59; 95% CI: 1.03 to 2.45; 4 studies) were also significantly increased.
CONCLUSIONS
Discontinuation of beta-blockers in patients admitted with ADHF was associated with significantly increased in-hospital mortality, short-term mortality, and the combined endpoint of short-term rehospitalization or mortality. These data suggest beta-blockers should be continued in ADHF patients if their clinical picture allows.
Topics: Adrenergic beta-Antagonists; Heart Failure; Humans; Observational Studies as Topic; Randomized Controlled Trials as Topic; Substance Withdrawal Syndrome; Survival Rate
PubMed: 26251094
DOI: 10.1016/j.jchf.2015.03.008 -
Ugeskrift For Laeger Mar 2019
Topics: Adrenergic beta-Antagonists; Anxiety Disorders; Humans; Propranolol
PubMed: 30931879
DOI: No ID Found -
Nuklearmedizin. Nuclear Medicine Feb 2018
Topics: Adrenergic beta-Antagonists; Animals; Drug Utilization; Humans; Parkinsonian Disorders; Propranolol
PubMed: 29536493
DOI: 10.3413/Nukmed-0947-17-11 -
Journal of the American College of... Apr 2022
Topics: Adrenergic beta-Antagonists; Cardiomyopathy, Hypertrophic; Exercise Test; Hemodynamics; Humans
PubMed: 35450574
DOI: 10.1016/j.jacc.2022.02.021 -
Circulation Research Nov 2018The actions and regulation of cardiomyocyte βARs differ in several respects from the properties described for the prototypical βAR subtype; a mechanism to explain the... (Review)
Review
The actions and regulation of cardiomyocyte βARs differ in several respects from the properties described for the prototypical βAR subtype; a mechanism to explain the unique properties of the βAR subtype has never been obvious. This viewpoint summarizes recent studies that identify a novel signaling paradigm for the βAR, implicating the N-terminus as a molecular determinant of βAR responsiveness.
Topics: Adrenergic beta-Antagonists; Animals; Heart Diseases; Humans; Myocytes, Cardiac; Receptors, Adrenergic, beta
PubMed: 30571467
DOI: 10.1161/CIRCRESAHA.118.313884 -
JAMA Cardiology Jul 2021
Topics: Adrenergic beta-Antagonists; Angiotensin Receptor Antagonists; Drug Therapy, Combination; Heart Failure; Humans; Mineralocorticoid Receptor Antagonists; Sodium-Glucose Transporter 2 Inhibitors; Time Factors
PubMed: 33787823
DOI: 10.1001/jamacardio.2021.0496 -
Angiology Mar 2022
Topics: Adrenergic beta-Antagonists; Angiotensin-Converting Enzyme Inhibitors; Humans; Kidney Diseases
PubMed: 34955032
DOI: 10.1177/00033197211063654 -
Cardiovascular & Hematological Agents... 2015Many clinically important differences exist between beta blockers. B1-selectivity is of clinical interest because at clinically used doses, b1- selective agents block... (Review)
Review
Many clinically important differences exist between beta blockers. B1-selectivity is of clinical interest because at clinically used doses, b1- selective agents block cardiac b-receptors while having minor effects on bronchial and vascular b-receptors. Beta-adrenergic blocking agents significantly decrease the frequency and duration of angina pectoris, instead the prognostic benefit of beta-blockers in stable angina has been extrapolated from studies of post myocardial infarction but has not yet been documented without left ventricular disfunction or previous myocardial infarction. Organic nitrates are among the oldest drugs, but they still remain a widely used adjuvant in the treatment of symptomatic coronary artery disease. While their efficacy in relieving angina pectoris symptoms in acute settings and in preventing angina before physical or emotional stress is undisputed, the chronic use of nitrates has been associated with potentially important side effects such as tolerance and endothelial dysfunction. B-blockers are the firstline anti-anginal therapy in stable stable angina patients without contraindications, while nitrates are the secondline anti-anginal therapy. Despite 150 years of clinical practice, they remain fascinating drugs, which in a chronic setting still deserve investigation. This review evaluated pharmacotherapy and indications of Beta-blockers and nitrates in stable angina.
Topics: Adrenergic beta-Antagonists; Angina Pectoris; Animals; Humans; Nitrates; Vasodilator Agents
PubMed: 25544116
DOI: 10.2174/1871525713666141219114708 -
Current Medicinal Chemistry 2017Evolution in computer engineering, availability of increasing amounts of data and the development of new and fast docking algorithms and software have led to improved... (Review)
Review
BACKGROUND
Evolution in computer engineering, availability of increasing amounts of data and the development of new and fast docking algorithms and software have led to improved molecular simulations with crucial applications in virtual high-throughput screening and drug discovery. Moreover, analysis of protein-ligand recognition through molecular docking has become a valuable tool in drug design.
OBJECTIVE
In this review, we focus on the applicability of molecular docking on a particular class of G protein-coupled receptors: the β-adrenergic receptors, which are relevant targets in clinic for the treatment of asthma and cardiovascular diseases.
RESULTS
We describe the binding site in β-adrenergic receptors to understand key factors in ligand recognition along with the proteins activation process. Moreover, we focus on the discovery of new lead compounds that bind the receptors, on the evaluation of virtual screening using the active/ inactive binding site states, and on the structural optimization of known families of binders to improve β-adrenergic affinity. We also discussed strengths and challenges related to the applicability of molecular docking in β-adrenergic receptors.
CONCLUSION
Molecular docking is a valuable technique in computational chemistry to deeply analyze ligand recognition and has led to important breakthroughs in drug discovery and design in the field of β-adrenergic receptors.
Topics: Adrenergic beta-Agonists; Adrenergic beta-Antagonists; Algorithms; Asthma; Cardiovascular Diseases; Drug Discovery; High-Throughput Screening Assays; Humans; Molecular Docking Simulation; Receptors, Adrenergic, beta; Software
PubMed: 28738772
DOI: 10.2174/0929867324666170724101448 -
Cancer Epidemiology, Biomarkers &... Sep 2021
Topics: Adrenergic beta-Antagonists; Angiotensin-Converting Enzyme Inhibitors; Breast Neoplasms; Female; Humans
PubMed: 34475119
DOI: 10.1158/1055-9965.EPI-21-0527