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The evaluation of β-adrenoceptor blocking agents in patients with COPD and congestive heart failure: a nationwide study
- Source :
- International Journal of Chronic Obstructive Pulmonary Disease
- Publication Year :
- 2017
- Publisher :
- Dove Medical Press, 2017.
-
Abstract
- Kuang-Ming Liao,1,* Tien-Yu Lin,2,3 Yaw-Bin Huang,2,3 Chen-Chun Kuo,2,* Chung-Yu Chen2,3 1Department of Internal Medicine, ChiMei Medical Center, Chiali, Tainan, 2School of Pharmacy, Kaohsiung Medical University, 3Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan,Republic of China *These authors contributed equally tothis work Objective: β-Blockers are safe and improve survival in patients with both congestive heart failure (CHF) and COPD. However, the superiority of different types of β-blockers is still unclear among patients with CHF and COPD. The association between β-blockers and CHF exacerbation as well as COPD exacerbation remains unclear. The objective of this study was to compare the outcome of different β-blockers in patients with concurrent CHF and COPD. Patients and methods: We used the National Health Insurance Research Database in Taiwan to conduct a retrospective cohort study. The inclusion criteria for CHF were patients who were>20years old and were diagnosed with CHF between January 1, 2005 and December 31,2012. COPD patients included those who had outpatient visit claims ≥2 times within 365days or 1 claim for hospitalization with a COPD diagnosis. A time-dependent Cox proportional hazards regression model was applied to evaluate the effectiveness of β-blockers in the study population. Results: We identified 1,872 patients with concurrent CHF and COPD. Only high-dose bisoprolol significantly reduced the risk of death and slightly decreased the hospitalization rate due to CHF exacerbation (death: adjusted hazard ratio [aHR]=0.51, 95% confidence interval [CI]=0.29–0.89; hospitalization rate due to CHF exacerbation: aHR=0.48, 95% CI=0.23–1.00). No association was observed between β-blocker use and COPD exacerbation. Conclusion: In patients with concurrent CHF and COPD, β-blockers reduced mortality, CHF exacerbation, and the need for hospitalization. Bisoprolol was found to reduce mortality and CHF exacerbation compared to carvedilol and metoprolol. Keywords: congestive heart failure, COPD, β-blockers, acute exacerbation
- Subjects :
- Male
Time Factors
Exacerbation
Databases, Factual
030204 cardiovascular system & hematology
Propanolamines
Pulmonary Disease, Chronic Obstructive
0302 clinical medicine
030212 general & internal medicine
Carvedilol
health care economics and organizations
Metoprolol
Original Research
Aged, 80 and over
COPD
Hazard ratio
General Medicine
Middle Aged
humanities
Hospitalization
congestive heart failure
Treatment Outcome
Bisoprolol
Cardiology
Disease Progression
Female
medicine.drug
circulatory and respiratory physiology
medicine.medical_specialty
Adrenergic beta-Antagonists
Carbazoles
Taiwan
International Journal of Chronic Obstructive Pulmonary Disease
03 medical and health sciences
Internal medicine
medicine
Humans
cardiovascular diseases
Propensity Score
acute exacerbation
Aged
Proportional Hazards Models
Retrospective Studies
Heart Failure
Chi-Square Distribution
business.industry
Retrospective cohort study
medicine.disease
respiratory tract diseases
Heart failure
β-blockers
business
Subjects
Details
- Language :
- English
- ISSN :
- 11782005 and 11769106
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- International Journal of Chronic Obstructive Pulmonary Disease
- Accession number :
- edsair.doi.dedup.....9b835143cddcc290214cf322db458cdd