Association of β-blocker use with survival and pulmonary function in patients with chronic obstructive pulmonary and cardiovascular disease: a systematic review and meta-analysis
| Autor: | Ruo-Lan Xiang, Zhi-Chun Xu, Yan-Li Yang, Zi-Jian Xiang, Jing-Hua Yang, Wen-Jie Wang |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
congenital
hereditary and neonatal diseases and abnormalities medicine.medical_specialty Lung Heart disease Exacerbation business.industry Hazard ratio 030204 cardiovascular system & hematology medicine.disease Placebo Pulmonary function testing law.invention 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Randomized controlled trial law Internal medicine medicine Respiratory function 030212 general & internal medicine Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal. 41:4415-4422 |
| ISSN: | 1522-9645 0195-668X |
| DOI: | 10.1093/eurheartj/ehaa793 |
| Popis: | Aims The aim of this study was to clarify the effect of β-blockers (BBs) on respiratory function and survival in patients with chronic obstructive pulmonary disease with cardiovascular disease (CVD), as well as the difference between the effects of cardioselective and noncardioselective BBs. Methods and results We searched for relevant literature in four electronic databases, namely, PubMed, EMBASE, Cochrane Library, and Web of Science, and compared the differences in various survival indicators between patients with chronic obstructive pulmonary disease taking BBs and those not taking BBs. Forty-nine studies were included, with a total sample size of 670 594. Among these, 12 studies were randomized controlled trials (RCTs; seven crossover and five parallel RCTs) and 37 studies were observational (including four post hoc analyses of data from RCTs). The hazard ratios (HRs) of chronic obstructive pulmonary disease exacerbation between patients with chronic obstructive pulmonary disease who were not treated with BBs and those who were treated with BBs, cardioselective BBs, and noncardioselective BBs were 0.77 [95% confidence interval (CI) 0.67, 0.89], 0.72 [95% CI 0.56, 0.94], and 0.98 [95% CI 0.71, 1.34, respectively] (HRs Conclusion The use of BBs in patients with chronic obstructive pulmonary disease is not only safe but also reduces their all-cause and in-hospital mortality. Cardioselective BBs may even reduce chronic obstructive pulmonary disease exacerbations. In addition, cardioselective BBs do not affect the action of bronchodilators. Importantly, BBs reduce the heart rate acceleration caused by bronchodilators. BBs should be prescribed freely when indicated in patients with chronic obstructive pulmonary disease and heart disease. |
| Databáze: | OpenAIRE |
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