Predischarge initiation of carvedilol in patients hospitalized for decompensated heart failure.


Journal Article

The use of beta-blockers for the treatment of heart failure in the United States is inadequate, despite available data and current guidelines that support their use. The Initiation Management Predischarge: Process for Assessment of Carvedilol Therapy for Heart Failure (IMPACT-HF) study was designed to determine whether initiation of beta-blockade before hospital discharge is safe and effective in improving the 60-day use of beta-blockers in patients with heart failure. IMPACT-HF compared the strategy of the initiation of carvedilol before patients were discharged versus usual care (Heart Failure Society of America guidelines recommend waiting 2 to 4 weeks after hospitalization for heart failure before initiating beta-blocker therapy) in 363 randomized patients with heart failure. The entry criteria were non-restrictive to ensure inclusion of patients reflective of the general heart failure population. The primary end point of the study (the number of patients treated with any beta-blocker at 60 days) was statistically significantly higher in the predischarge group versus the postdischarge group (91.2% vs 73.4%, respectively). Based on the study's results, predischarge initiation may be a successful strategy to improve the use of beta-blocker therapy for patients with heart failure.

Full Text

Duke Authors

Cited Authors

  • Gattis, WA; O'Connor, CM

Published Date

  • May 6, 2004

Published In

Volume / Issue

  • 93 / 9A

Start / End Page

  • 74B - 76B

PubMed ID

  • 15144943

Pubmed Central ID

  • 15144943

International Standard Serial Number (ISSN)

  • 0002-9149

Digital Object Identifier (DOI)

  • 10.1016/j.amjcard.2004.01.019


  • eng

Conference Location

  • United States