{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T20:36:15Z","timestamp":1788726975299,"version":"build-2803163510"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T00:00:00Z","timestamp":1487894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The use of \u03b2-blockers represents a milestone in the treatment of heart failure with reduced ejection fraction (HFrEF). Few studies have compared \u03b2-blockers in HFrEF, and there is little data on the effects of different doses. The present study aimed to investigate in a large database of HFrEF patients (MECKI score database) the association of \u03b2-blocker treatment with a composite outcome of cardiovascular death, urgent heart transplantation or left ventricular assist device implantation, addressing the role of \u03b2-selectivity and dosage regimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In 5242 HFrEF patients, we investigated the role of: (i) \u03b2-blocker treatment vs. non-\u03b2-blocker treatment, (ii) \u03b21-\/\u03b22-receptor-blockers vs. \u03b21-selective blockers, and (iii) daily \u03b2-blocker dose. Patients were followed for 3.58\u2009years, and 1101 events (18.3%) were observed; 4435 patients (86.8%) were on \u03b2-blockers, while 807 (13.2%) were not. At 5\u2009years, \u03b2-blocker-patients showed a better outcome than non-\u03b2-blocker-subjects [hazard ratio (HR) 0.48, P\u2009&amp;lt;\u20090.0001], while also considering potential confounders. A comparable prognosis was observed at 5\u2009years in the \u03b21-\/\u03b22-receptor-blocker (n\u2009=\u20092219) vs. \u03b21-selective group (n\u2009=\u20092216) (HR 0.95, P\u2009=\u2009ns). A better prognosis was observed in high-dose (&amp;gt;2\u20095\u2009mg carvedilol equivalent daily dose, n\u2009=\u20091005) patients than in both medium dose (12.5\u201325\u2009mg, n\u2009=\u20091431) and low dose (&amp;lt;12.5\u2009mg, n\u2009=\u20091960) (HR 1.97, P\u2009&amp;lt;\u20090.001; HR 1.95, P\u2009=\u20090.001, respectively), with no differences between the last two groups (HR 0.84, P\u2009=\u2009ns).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a large population of chronic HFrEF patients, \u03b2-blockers were associated with a more favourable prognosis without any difference between \u03b21- and \u03b22-receptor-blockers vs. \u03b21-selective blockers. A better outcome was observed in subjects receiving a high daily dose.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.775","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T00:32:41Z","timestamp":1487896361000},"page":"904-914","source":"Crossref","is-referenced-by-count":30,"title":["Prognostic Role of \u03b2-Blocker Selectivity and Dosage Regimens in Heart Failure Patients. Insights from the MECKI Score Database"],"prefix":"10.1093","volume":"19","author":[{"given":"Stefania","family":"Paolillo","sequence":"first","affiliation":[{"name":"IRCCS SDN , Naples ,","place":["Italy"]},{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Mapelli","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Bonomi","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugo","family":"Corr\u00e0","sequence":"additional","affiliation":[{"name":"Division of Cardiac Rehabilitation, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Veruno , Veruno ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Piepoli","sequence":"additional","affiliation":[{"name":"Cardiac Department, Guglielmo da Saliceto Hospital , Piacenza ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Veglia","sequence":"additional","affiliation":[{"name":"IRCCS SDN , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Salvioni","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Gentile","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Ospedali Riuniti and University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Lagioia","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Cassano Murge , Bari ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Limongelli","sequence":"additional","affiliation":[{"name":"Cardiology SUN, Monaldi Hospital (Azienda dei Colli), Second University of Naples , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Sinagra","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Ospedali Riuniti and University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Cattadori","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation, San Giuseppe Hospital, Multimedica Spa, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela B.","family":"Scardovi","sequence":"additional","affiliation":[{"name":"Cardiology Division, Santo Spirito Hospital , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Carubelli","sequence":"additional","affiliation":[{"name":"Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Scrutino","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Cassano Murge , Bari ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Badagliacca","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology, and Geriatric Sciences, \u2018Sapienza\u2019 University of Rome , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Raimondo","sequence":"additional","affiliation":[{"name":"Salvatore Maugeri, Foundation IRCCS, Scientific Institute of Tradate \u00a0","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Emdin","sequence":"additional","affiliation":[{"name":"Life Science Institute, Scuola Superiore Sant'Anna , Pisa ,","place":["Italy"]},{"name":"Gabriele Monasterio, Foundation CNR-Regione Toscana , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damiano","family":"Magr\u00ec","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, \u2018Sapienza\u2019 University of Rome , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Correale","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Foggia , Foggia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Parati","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano , Milan ,","place":["Italy"]},{"name":"Department of Medicine and Surgery, University of Milano-Bicocca , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Caravita","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Spadafora","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Re","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiac Arrhythmia Centre and Cardiomyopathies Unit, San Camillo-Forlanini Hospital , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariantonietta","family":"Cicoira","sequence":"additional","affiliation":[{"name":"Section of Cardiology, Department of Medicine, University of Verona , Verona ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Frigerio","sequence":"additional","affiliation":[{"name":"\u2018A. De Gasperis\u2019 Cardio Center, Niguarda Hospital , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Bussotti","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Unit, Salvatore Maugeri, Foundation, IRCCS, Scientific Institute of Milan , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Min\u00e0","sequence":"additional","affiliation":[{"name":"Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation IRCCS \u2013 ISMETT , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Oliva","sequence":"additional","affiliation":[{"name":"\u2018A. De Gasperis\u2019 Cardio Center, Niguarda Hospital , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Battaia","sequence":"additional","affiliation":[{"name":"Department of Cardiology, S. Chiara Hospital , Trento ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romualdo","family":"Belardinelli","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation, Azienda Ospedali Riuniti , Ancona ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Mezzani","sequence":"additional","affiliation":[{"name":"Division of Cardiac Rehabilitation, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Veruno , Veruno ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Pastormerlo","sequence":"additional","affiliation":[{"name":"Gabriele Monasterio, Foundation CNR-Regione Toscana , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Di Lenarda","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Health Authority n. 1 and University of Trieste , Trieste 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Ospedali Riuniti and University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Guazzi","sequence":"additional","affiliation":[{"name":"Cardiology University Department, Heart Failure Unit and Cardiopulmonary Laboratory, IRCCS Policlinico San Donato , San Donato, Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Pacileo","sequence":"additional","affiliation":[{"name":"Cardiology SUN, Monaldi Hospital (Azienda dei Colli), Second University of Naples , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Ricci","sequence":"additional","affiliation":[{"name":"Cardiology Division, Santo Spirito Hospital , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Contini","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Apostolo","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Palermo","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Clemenza","sequence":"additional","affiliation":[{"name":"Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation IRCCS \u2013 ISMETT , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Marchese","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, \u2018Sapienza\u2019 University of Rome , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Binno","sequence":"additional","affiliation":[{"name":"Cardiac Department, Guglielmo da Saliceto Hospital , Piacenza ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Passantino","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Cassano Murge , Bari ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Perrone Filardi","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, \u2018Federico II\u2019 University of Naples , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piergiuseppe","family":"Agostoni","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]},{"name":"Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,2,24]]},"reference":[{"key":"2026011721190033600_ejhf775-bib-0001","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/ejhf.592","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). 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