%V 22 %K Heart failure, Elderly, Beta-blocker, SwedeHF, Registry %N 1 %T Association between betaâ€blocker use and mortality/morbidity in older patients with heart failure with reduced ejection fraction. A propensity scoreâ€matched analysis from the Swedish Heart Failure Registry %D 2020 %P 103-112 %X BACKGROUND: Betaâ€blockers reduce mortality and morbidity in heart failure (HF) with reduced ejection fraction (HFrEF). However, patients older than 80 years are poorly represented in randomized controlled trials. We assessed the association between betaâ€blocker use and outcomes in HFrEF patients aged ≥80 years. METHODS AND RESULTS: We included patients with an ejection fraction <40% and aged ≥80 years from the Swedish HF Registry. The association between betaâ€blocker use, allâ€cause mortality and cardiovascular (CV) mortality/HF hospitalization was assessed by Cox proportional hazard models in a 1:1 propensity scoreâ€matched cohort. To assess consistency, the same analyses were performed in a positive control cohort with age <80 years. A negative control outcome analysis was run using hospitalization for cancer as endpoint. Of 6562 patients aged ≥80 years, 5640 (86%) received betaâ€blockers. In the matched cohort including 1732 patients, betaâ€blocker use was associated with a significant reduction in the risk of allâ€cause mortality [hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.79–0.99]. Reduction in CV mortality/HF hospitalization was not significant (HR 0.94, 95% CI 0.85–1.05) due to the lack of association with HF hospitalization, whereas CV death was significantly reduced. After adjustment rather than matching for the propensity score in the overall cohort, betaâ€blocker use was associated with reduced risk of all outcomes. In patients aged <80 years, use of betaâ€blockers was associated with reduced risk of allâ€cause death (HR 0.79, 95% CI 0.68–0.92) and of the composite outcome (HR 0.88, 95% CI 0.77–0.99). CONCLUSIONS: In HFrEF patients ≥80 years of age, use of betaâ€blockers was high and was associated with improved allâ€cause and CV survival. %O This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. %A D Stolfo %A A Uijl %A L Benson %A B Schrage %A M Fudim %A FW Asselbergs %A S Koudstaal %A G Sinagra %A U Dahlstroem %A G Rosano %A G Savarese %J European Journal of Heart Failure %L discovery10088513 %I WILEY