Impact of β-blockers on in-hospital mortality in patients with heart failure: a retrospective propensity-score matched analysis based on MIMIC-IV database

Introduction: This study assessed the relationship between beta-blockers treatment and in-hospital mortality among individuals diagnosed with heart failure (HF). Methods: A retrospective cohort study was carried out on 9,968 HF patients sourced from the Medical Information Mart for Intensive Care (MIMIC)-IV database. Propensity score matching (PSM) was employed to balance the baseline differences. A multivariate regression analysis was utilized to evaluate the impact of beta-blockers therapy on in-hospital mortality. Results: Among the 9,968 patients, 6,439 (64.6%) were beta-blockers users. Before matching, the overall in-hospital mortality rate was 12.2% (1,217/9,968). Following PSM, a total of 3,212 patient pairs were successfully matched. The analysis revealed a correlation between beta-blockers therapy and decreased in-hospital mortality (odds ratio 0.51 [0.43-0.60], P < 0.001), as well as shorter Los (length of stay) hospital (beta -1.43 [-1.96 similar to-0.09], P < 0.001). Notably, long-acting beta-blockers treatment was linked to a decreased risk of in-hospital mortality (odds ratio 0.55 [0.46-0.65], P < 0.001) and a shorter Los hospital (beta -1.21 [-1.80 similar to-0.63], P < 0.001). Conversely, the research results did not show a notable decrease in-hospital mortality (odds ratio 0.66 [0.44-1.01], P = 0.051) or Los hospital (beta -1.01 [-2.2 similar to-0.25], P = 0.117) associated with short-acting beta-blocker therapy. Discussion: beta-blockers therapy in the intensive care unit demonstrates potential benefits in lowering the risk of in-hospital mortality and reducing the duration of hospitalization among patients with HF. Specifically, long-acting beta-blockers exhibit a protective effect by significantly decreasing both in-hospital mortality and Los hospital. Conversely, the study did not observe a substantial impact on in-hospital mortality or Los hospital duration in this cohort of patients following the administration of short-acting beta-blockers.