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Evaluation of β-blocker Dose Optimisation Among Patients Attending Heart Failure Clinic at Sarawak Heart Centre, Malaysia

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Objective: The aim of the study was to evaluate the rate of optimisation of β-blockers to target dose among patients attending the heart failure clinic at Sarawak Heart Centre, Kuching, Malaysia.

Materials and methods: Data were collected retrospectively all the patients who registered from January 2016 to June 2018 and had at least 6 months follow-up period with the heart failure clinic.

Results: A total of 106 patients were recruited and 85.8% of them were men. Of the 106 patients, 9.4% were initiated with β-blockers in heart failure clinic and 90.6% of the patients had uptitration of their β-blocker therapy in the clinic. By the tenth clinic visits, 83.1% patients achieved ≥50% of target dose of β-blockers and 56.9% of them achieved 100% target dose. After 6 months of follow-up, 87.7% patients tolerated ≥ 50% of target dose of β-blocker and 45.3% of them tolerated 100% target dose. The baseline median heart rate was 73.5 BPM and the median heart rate was reduced to 64 BPM after 10 clinic visits. The number of patients with suboptimal heart rate (≥ 70 BPM) was 32.3% after 10 clinic visits and within this group, 80.9% of them were on ≥50% of β-blocker target dose while 61.9% were on 100% target dose.

Conclusion: In conclusion, β-blocker optimisation in the heart failure clinic at Sarawak Heart Centre is achieved in more than 75% of the patients who tolerated ≥50% target dose and in approximately half of the patients who tolerated 100% target dose after 6 months’ follow-up.