Impact of Β-Blockers on In-Hospital Mortality in Patients with Heart Failure: a Retrospective Propensity-Score Matched Analysis Based on MIMIC-IV Database

IntroductionThis study assessed the relationship between β-blockers treatment and in-hospital mortality among individuals diagnosed with heart failure (HF).MethodsA 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 β-blockers therapy on in-hospital mortality.ResultsAmong the 9,968 patients, 6,439 (64.6%) were β-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 β-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 (β −1.43 [−1.96∼−0.09], P < 0.001). Notably, long-acting β-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 (β −1.21 [−1.80∼−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 (β −1.01 [−2.2∼−0.25], P = 0.117) associated with short-acting β-blocker therapy.Discussionβ-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 β-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 β-blockers.