{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T02:33:22Z","timestamp":1771554802310,"version":"3.50.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Egypt Heart J"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The beta-blocker (BB) initiation in acute heart failure (AHF) patients is still controversial. Some show the benefit of BB employment in decreasing the mortality outcome. This study aims to assess the safety and efficacy of in-hospital and long-term outcomes of BB initiation in AHF hospitalized patients. We searched multiple databases examining the outcome of AHF patients who had administered BB as the therapy initiation. Primary outcomes were all-cause mortality, composite endpoint after BB initiation when hospitalized, and post-discharge all-cause mortality. The secondary outcomes were adverse events after in-hospital BB initiation, including hypotension and symptomatic bradycardia after BB initiation when hospitalization and rehospitalization.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Eight cohort studies with 16,639 patients suffering from AHF and cardiogenic shock, with 9923 participants allocated to the early BB group and 6,713 patients in the control group. The follow-up durations ranged from 2 to 24\u00a0months. Early BB administration significantly reduced in-hospital composite endpoints (RR: 0.42; 95% CI (0.30\u20130.58); <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), in-hospital all-cause mortality (RR: 0.43; 95% CI (0.31\u20130.61); <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), discharge mortality (RR: 0.51; 95% CI (0.41\u20130.63); <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and rehospitalization (RR: 0.57; 95% CI (0.44\u20130.74); <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). There were no discernible differences in in-hospital BB-related adverse events between the two groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.13). Subgroup analyses conducted on AHF patients presenting with cardiogenic shock revealed no significant differences in in-hospital composite endpoint and in-hospital mortality, and similar results were shown in the naive BB population.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The BB initiation in AHF patients shows advantages in efficacy and safety outcome.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s43044-024-00558-3","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T17:02:39Z","timestamp":1726246959000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Safety and efficacy of early beta-blocker initiation in acute heart failure and cardiogenic shock: systematic review and meta-analysis"],"prefix":"10.1186","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4612-1101","authenticated-orcid":false,"given":"Cyndiana Widia Dewi","family":"Sinardja","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gusti Ngurah Prana","family":"Jagannatha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan Gervais","family":"de Liyis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasya Maria","family":"Kosasih","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,9,13]]},"reference":[{"issue":"6","key":"558_CR1","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1001\/jama.289.6.712","volume":"289","author":"H Krum","year":"2003","unstructured":"Krum H, Roecker EB, Mohacsi P et al (2003) Effects of initiating carvedilol in patients with severe chronic heart failure. JAMA 289(6):712\u2013718. https:\/\/doi.org\/10.1001\/jama.289.6.712","journal-title":"JAMA"},{"issue":"1","key":"558_CR2","first-page":"380","volume":"71","author":"CT Cole-Jeffrey","year":"1999","unstructured":"Cole-Jeffrey CT, Pepine CJ, Katovich MJ, Grant MB, Raizada MK, Hazra S (1999) Beneficial effects of Angiotensin-(1\u20137) on CD34+ cells from heart failure patients. J Integr Cardiol 71(1):380\u2013386","journal-title":"J Integr Cardiol"},{"issue":"4","key":"558_CR3","first-page":"184","volume":"5","author":"D Tepper","year":"1999","unstructured":"Tepper D (1999) Effect of metoprolol CR\/XL in chronic heart failure: Metoprolol CR\/XL randomised intervention trial in congestive heart failure (MERIT-HF). Congest Heart Fail 5(4):184\u2013185","journal-title":"Congest Heart Fail"},{"issue":"21","key":"558_CR4","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1056\/NEJM199605233342101","volume":"334","author":"M Packer","year":"1996","unstructured":"Packer M, Bristow M, Cohn JN et al (1996) The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med 334(21):1349\u20131355","journal-title":"N Engl J Med"},{"issue":"36","key":"558_CR5","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","volume":"42","author":"TA McDonagh","year":"2021","unstructured":"McDonagh TA, Metra M, Adamo M et al (2021) 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 42(36):3599\u20133726. https:\/\/doi.org\/10.1093\/eurheartj\/ehab368","journal-title":"Eur Heart J"},{"issue":"7","key":"558_CR6","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1001\/jama.287.7.883","volume":"287","author":"JM Foody","year":"2002","unstructured":"Foody JM, Farrell MH, Krumholz HM (2002) Beta-blocker therapy in heart failure. JAMA 287(7):883\u2013889","journal-title":"JAMA"},{"issue":"7","key":"558_CR7","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1002\/ejhf.2888","volume":"25","author":"M Metra","year":"2023","unstructured":"Metra M, Adamo M, Tomasoni D, Mebazaa A, Bayes-Genis A, Abdelhamid M et al (2023) Pre-discharge and early post-discharge management of patients hospitalized for acute heart failure: a scientific statement by the Heart Failure Association of the ESC. Eur J Heart Fail 25(7):1115\u20131131. https:\/\/doi.org\/10.1002\/ejhf.2888","journal-title":"Eur J Heart Fail"},{"issue":"1","key":"558_CR8","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1002\/ehf2.14591","volume":"11","author":"T Abdurashidova","year":"2024","unstructured":"Abdurashidova T, M\u00fcller M, Schukraft S, Soborun N, Pitta-Gros B, Kiko\u00efne J et al (2024) European Society of Cardiology guidelines and 1-year outcomes of acute heart failure treatment in Central Asia and Europe. ESC Heart Fail 11(1):483\u2013491. https:\/\/doi.org\/10.1002\/ehf2.14591","journal-title":"ESC Heart Fail"},{"issue":"5","key":"558_CR9","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1097\/CCM.0b013e31820a91ed","volume":"39","author":"M B\u00f6hm","year":"2011","unstructured":"B\u00f6hm M, Link A, Cai D et al (2011) Beneficial association of \u03b2-blocker therapy on recovery from severe acute heart failure treatment: data from the survival of patients with acute heart failure in need of intravenous inotropic support trial. Crit Care Med 39(5):940\u2013944. https:\/\/doi.org\/10.1097\/CCM.0b013e31820a91ed","journal-title":"Crit Care Med"},{"issue":"18","key":"558_CR10","doi-asserted-by":"publisher","first-page":"2186","DOI":"10.1093\/eurheartj\/ehp323","volume":"30","author":"G Jondeau","year":"2009","unstructured":"Jondeau G, Neuder Y, Eicher JC et al (2009) B-CONVINCED: beta-blocker continuation vs. interruption in patients with congestive heart failure hospitalized for a decompensation episode. Eur Heart J. 30(18):2186\u20132192. https:\/\/doi.org\/10.1093\/eurheartj\/ehp323","journal-title":"Eur Heart J."},{"key":"558_CR11","doi-asserted-by":"crossref","unstructured":"Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7)","DOI":"10.1371\/journal.pmed.1000097"},{"key":"558_CR12","volume-title":"Newcastle\u2013Ottawa quality assessment form for cohort studies","author":"G Wells","year":"1932","unstructured":"Wells G, Shea B, O\u2019Connell D, Peterson J, Welch VLM (1932) Newcastle\u2013Ottawa quality assessment form for cohort studies. Ottawa Hospital Research Institute, Ottawa"},{"key":"558_CR13","unstructured":"Khalid MM, Galuska MA, Hamilton RJ (2023) Beta-blocker toxicity. In: StatPearls [Internet]. StatPearls Publishing, Treasure Island"},{"issue":"3","key":"558_CR14","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","volume":"7","author":"R Dersimonian","year":"1986","unstructured":"Dersimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177\u2013188","journal-title":"Control Clin Trials"},{"issue":"7109","key":"558_CR15","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","volume":"315","author":"M Egger","year":"1997","unstructured":"Egger M, Smith GD, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629\u2013634","journal-title":"BMJ"},{"key":"558_CR16","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.019240","author":"N Enzan","year":"2021","unstructured":"Enzan N, Matsushima S, Ide T et al (2021) Beta-blocker use is associated with prevention of left ventricular remodeling in recovered dilated cardiomyopathy. J Am Heart Assoc. https:\/\/doi.org\/10.1161\/JAHA.120.019240","journal-title":"J Am Heart Assoc."},{"issue":"1","key":"558_CR17","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1093\/eurheartj\/ehx564","volume":"39","author":"JGF Cleland","year":"2018","unstructured":"Cleland JGF, Bunting KV, Flather MD et al (2018) Beta-blockers for heart failure with reduced, mid-range, and preserved ejection fraction: an individual patient-level analysis of double-blind randomized trials. Eur Heart J 39(1):26\u201335. https:\/\/doi.org\/10.1093\/eurheartj\/ehx564","journal-title":"Eur Heart J"},{"issue":"2","key":"558_CR18","doi-asserted-by":"publisher","first-page":"00624","DOI":"10.1183\/23120541.00624-2020","volume":"7","author":"L Karimi","year":"2021","unstructured":"Karimi L, Lahousse L, De Nocker P, Stricker BH, Brusselle GG, Verhamme KMC (2021) Effect of \u03b2-blockers on the risk of COPD exacerbations according to indication of use: the Rotterdam Study. ERJ Open Res 7(2):00624\u201302020. https:\/\/doi.org\/10.1183\/23120541.00624-2020","journal-title":"ERJ Open Res"},{"issue":"1","key":"558_CR19","doi-asserted-by":"publisher","first-page":"41","DOI":"10.4103\/heartviews.heartviews_75_22","volume":"24","author":"O Khan","year":"2023","unstructured":"Khan O, Patel M, Tomdio AN, Beall J, Jovin IS (2023) Beta-blockers in the prevention and treatment of ischemic heart disease: Evidence and clinical practice. Heart Views 24(1):41\u201349. https:\/\/doi.org\/10.4103\/heartviews.heartviews_75_22","journal-title":"Heart Views"},{"issue":"1","key":"558_CR20","doi-asserted-by":"publisher","first-page":"77","DOI":"10.2174\/157340312801215764","volume":"8","author":"A Kezerashvili","year":"2012","unstructured":"Kezerashvili A, Marzo K, De Leon J (2012) Beta-blocker use after acute myocardial infarction in the patient with normal systolic function: When is it \u2018ok\u2019 to discontinue? Curr Cardiol Rev 8(1):77\u201384. https:\/\/doi.org\/10.2174\/157340312801215764","journal-title":"Curr Cardiol Rev"},{"key":"558_CR21","doi-asserted-by":"publisher","first-page":"735841","DOI":"10.3389\/fphar.2021.735841","volume":"12","author":"R Bruning","year":"2021","unstructured":"Bruning R, Dykes H, Jones TW, Wayne NB, Sikora NA (2021) Beta-adrenergic blockade in critical illness. Front Pharmacol 12:735841. https:\/\/doi.org\/10.3389\/fphar.2021.735841","journal-title":"Front Pharmacol"},{"issue":"8","key":"558_CR22","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.3390\/ph4081088","volume":"4","author":"K Nakamura","year":"2011","unstructured":"Nakamura K, Murakami M, Miura D et al (2011) Beta-blockers and oxidative stress in patients with heart failure. Pharmaceuticals (Basel) 4(8):1088\u20131100. https:\/\/doi.org\/10.3390\/ph4081088","journal-title":"Pharmaceuticals (Basel)"},{"key":"558_CR23","doi-asserted-by":"publisher","first-page":"104149","DOI":"10.1016\/j.ebiom.2022.104149","volume":"82","author":"M Rossi","year":"2022","unstructured":"Rossi M, Talbot J, Piris P et al (2022) Beta-blockers disrupt mitochondrial bioenergetics and increase radiotherapy efficacy independently of beta-adrenergic receptors in medulloblastoma. EBioMedicine 82:104149. https:\/\/doi.org\/10.1016\/j.ebiom.2022.104149","journal-title":"EBioMedicine"},{"issue":"5","key":"558_CR24","doi-asserted-by":"publisher","first-page":"1337","DOI":"10.1113\/JP277494","volume":"597","author":"AB Shah","year":"2019","unstructured":"Shah AB, Bechis MZ, Brown M et al (2019) Catecholamine response to exercise in patients with non-obstructive hypertrophic cardiomyopathy. J Physiol 597(5):1337\u20131346. https:\/\/doi.org\/10.1113\/JP277494","journal-title":"J Physiol"},{"key":"558_CR25","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.020012","author":"Y Tamaki","year":"2021","unstructured":"Tamaki Y, Yaku H, Morimoto T et al (2021) Lower in-hospital mortality with beta-blocker use at admission in patients with acute decompensated heart failure. J Am Heart Assoc. https:\/\/doi.org\/10.1161\/JAHA.120.020012","journal-title":"J Am Heart Assoc."},{"key":"558_CR26","doi-asserted-by":"publisher","first-page":"779462","DOI":"10.3389\/fcvm.2022.779462","volume":"9","author":"C Liang","year":"2022","unstructured":"Liang C, Zhang C, Gan S, Chen X, Tan Z (2022) Long-term effect of \u03b2-blocker use on clinical outcomes in postmyocardial infarction patients: a systematic review and meta-analysis. Front Cardiovasc Med 9:779462. https:\/\/doi.org\/10.3389\/fcvm.2022.779462","journal-title":"Front Cardiovasc Med"},{"issue":"1","key":"558_CR27","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s13613-023-01130-z","volume":"13","author":"H Merdji","year":"2023","unstructured":"Merdji H, Levy B, Jung C, Ince C, Siegemund M, Meziani F (2023) Microcirculatory dysfunction in cardiogenic shock. Ann Intensive Care 13(1):38. https:\/\/doi.org\/10.1186\/s13613-023-01130-z","journal-title":"Ann Intensive Care"},{"issue":"1","key":"558_CR28","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1186\/s13054-021-03706-2","volume":"25","author":"P Di Santo","year":"2021","unstructured":"Di Santo P, Mathew R, Jung RG et al (2021) Impact of baseline beta-blocker use on inotrope response and clinical outcomes in cardiogenic shock: a subgroup analysis of the DOREMI trial. Crit Care 25(1):289. https:\/\/doi.org\/10.1186\/s13054-021-03706-2","journal-title":"Crit Care"},{"key":"558_CR29","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0006411","author":"S von Haehling","year":"2009","unstructured":"von Haehling S, Schefold JC, Jankowska E et al (2009) Leukocyte redistribution: effects of beta blockers in patients with chronic heart failure. PLoS One. https:\/\/doi.org\/10.1371\/journal.pone.0006411","journal-title":"PLoS One."},{"key":"558_CR30","doi-asserted-by":"publisher","first-page":"1263482","DOI":"10.3389\/fcvm.2023.1263482","volume":"10","author":"G Schurtz","year":"2023","unstructured":"Schurtz G, Mewton N, Lemesle G et al (2023) Beta-blocker management in patients admitted for acute heart failure and reduced ejection fraction: a review and expert consensus opinion. Front Cardiovasc Med 10:1263482. https:\/\/doi.org\/10.3389\/fcvm.2023.1263482","journal-title":"Front Cardiovasc Med"},{"key":"558_CR31","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-23-0815","author":"A Hirata","year":"2023","unstructured":"Hirata A, Hirata T (2023) Clinical practice for acute heart failure in Japan from the nationwide registry. Circ J. https:\/\/doi.org\/10.1253\/circj.CJ-23-0815","journal-title":"Circ J"}],"container-title":["The Egyptian Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-024-00558-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s43044-024-00558-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-024-00558-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T17:04:39Z","timestamp":1726247079000},"score":1,"resource":{"primary":{"URL":"https:\/\/tehj.springeropen.com\/articles\/10.1186\/s43044-024-00558-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,13]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["558"],"URL":"https:\/\/doi.org\/10.1186\/s43044-024-00558-3","relation":{},"ISSN":["2090-911X"],"issn-type":[{"value":"2090-911X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,13]]},"assertion":[{"value":"10 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 September 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 September 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was registered in the prospective international register of systematic reviews under the protocol number CRD42023486871 further reinforcing the systematic and standardized approach employed in this investigation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"This manuscript does not need any written informed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publications"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"126"}}