Use of Beta-Blockers in Patients with Heart Failure and Their Impact on Hospitalization Frequency

Resumen

Heart failure (HF) is a leading cause of morbidity, mortality, and healthcare utilization worldwide. β-blockers are a cornerstone of guideline-directed medical therapy, yet uncertainties remain regarding their impact on hospitalization frequency, particularly when therapy is suboptimally dosed. In this retrospective study, we analyzed 480 patients with HF treated at two tertiary hospitals between January 2022 and June 2024, stratified into three groups: no β-blocker therapy, suboptimal therapy, and optimal therapy (≥50% of the target dose). The primary outcome was hospitalization frequency within 12 months, while secondary outcomes included 30-day readmission and median length of stay. Patients without β-blocker therapy had the highest hospitalization rate (62.1%), compared with 47.3% in the suboptimal group and 33.7% in the optimal therapy group. Rehospitalization within 30 days occurred in 22.9%, 15.8%, and 8.0% of patients, respectively, and median length of stay declined progressively from 8 days in untreated patients to 6 days in those optimally treated. Multivariate analysis confirmed that absence of β-blockers and suboptimal therapy were strong predictors of hospitalization, along with diabetes mellitus and reduced ejection fraction. These findings confirm that optimal β-blocker therapy is associated with fewer hospitalizations, reduced early readmissions, and shorter hospital stays, underscoring the importance of both initiation and dose optimization as key strategies in HF management.