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Rapid carvedilol up-titration in hospitalized patients with left ventricular systolic dysfunction--data from the Carvedilol in Hospital: Up-titration Limits after Acute Patients Admission registry

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dc.contributor.author Martínez Sellés Oliveria Soares, Manuel spa
dc.contributor.author Datino, Tomás spa
dc.contributor.author Alhama, Marta spa
dc.contributor.author Barrueco, Nélida spa
dc.contributor.author Castillo, Isabel spa
dc.contributor.author Fernández-Avilés, Francisco spa
dc.date.accessioned 2013-11-27T17:26:32Z
dc.date.available 2013-11-27T17:26:32Z
dc.date.issued 2010 spa
dc.identifier.citation Martínez-Sellés, M., Datino, T., Alhama, M., Barrueco, N., Castillo, I., & Fernández-Avilés, F. (2010). Rapid carvedilol up-titration in hospitalized patients with left ventricular systolic dysfunction–data from the Carvedilol in hospital: up-titration limits after acute patients admission registry. Journal of Cardiovascular Medicine, 11(5), 352-358. spa
dc.identifier.issn 15582035 spa
dc.identifier.uri http://hdl.handle.net/11268/824
dc.description.abstract Background and Objective: Methods: Results: Conclusion: The safety of rapid carvedilol up-titration in patients with depressed left ventricular ejection fraction (LVEF) is unknown. The aim of the present work was to assess whether carvedilol can be used safely and rapidly up-titrated before hospital discharge in patients with left ventricular systolic dysfunction, with or without heart failure symptoms.We studied 611 patients with LVEF less than 0.4 in whom carvedilol was used during hospital admission.Mean age was 66 years, 23% were women and 372 had symptoms of heart failure. Carvedilol was initiated 3 days after admission (median); 594 patients (97%) were discharged alive, 27 (5%) without beta-blockers. Carvedilol up-titration during admission was performed in 65%. The mean time of up-titration was 1 week, with a mean increase of 16 mg/day. The discharge dose was higher in younger patients and in those weighing more than 70 kg. Only 30 patients (5%) were re-admitted during the first month after discharge. At the end of follow-up (mean 2.3 years), 497 patients were alive and transplant-free (81%). Carvedilol mean daily dose at the end of follow-up was 32.4 +/- 22.2 mg and was related to the discharge dose. The absence of beta-blocker treatment at discharge was the most important independent predictor of long-term mortality (hazard ratio 3.1, 95% confidence interval 1.5-6.2, P = 0.002).Carvedilol up-titration is well tolerated in patients hospitalized with depressed LVEF, with or without heart failure, with a high compliance rate at discharge and in the long term. spa
dc.language.iso eng spa
dc.subject.other Adrenergic Beta-Antagonists/*Administration & Dosage spa
dc.subject.other Carbazoles/*Administration & Dosage spa
dc.subject.other Heart Failure, Systolic/*Drug Therapy spa
dc.subject.other Propanolamines/*Administration & Dosage spa
dc.subject.other Ventricular Dysfunction, Left/*Drug Therapy spa
dc.subject.other Adrenergic Beta-Antagonists/Adverse Effects spa
dc.subject.other Carbazoles/Adverse Effects spa
dc.subject.other Female spa
dc.subject.other Heart Failure, Systolic/Mortality spa
dc.subject.other Humans spa
dc.subject.other Male spa
dc.subject.other Middle Aged spa
dc.subject.other Patient Discharge spa
dc.subject.other Propanolamines/Adverse Effects spa
dc.subject.other Spain/Epidemiology spa
dc.subject.other Treatment Outcome spa
dc.subject.other Ventricular Dysfunction, Left/Mortality spa
dc.title Rapid carvedilol up-titration in hospitalized patients with left ventricular systolic dysfunction--data from the Carvedilol in Hospital: Up-titration Limits after Acute Patients Admission registry spa
dc.type article spa
dc.description.impact 0.786 JCR (2010) Q4, 97/114 Cardiac & cardiovascular systems spa
dc.identifier.doi 10.2459/JCM.0b013e328334f48b spa
dc.rights.accessRights closedAccess en
dc.subject.unesco Enfermedad cardiovascular spa
dc.subject.unesco Tratamiento médico spa
dc.peerreviewed Si spa


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