Comparison of Long-Term Clinical Implications of Beta-Blockade in Patients With Obstructive Airway Diseases Exposed to Beta-Blockers With Different β1-Adrenoreceptor Selectivity: An Italian Population-Based Cohort Study

Autor: Maurizio Sessa, Annamaria Mascolo, Cristina Scavone, Ilaria Perone, Annalisa Di Giorgio, Michele Tari, Annamaria Fucile, Antonella De Angelis, Daniel Bech Rasmussen, Magnus Thorsten Jensen, Kristian Kragholm, Francesco Rossi, Annalisa Capuano, Liberata Sportiello
Přispěvatelé: Sessa, Maurizio, Mascolo, Annamaria, Scavone, Cristina, Perone, Ilaria, Giorgio, Annalisa Di, Tari, Michele, Fucile, Annamaria, De Angelis, Antonella, Rasmussen, Daniel Bech, Jensen, Magnus Thorsten, Kragholm, Kristian, Rossi, Francesco, Capuano, Annalisa, Sportiello, Liberata
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Sessa, M, Mascolo, A, Scavone, C, Perone, I, Di Giorgio, A, Tari, M, Fucile, A, De Angelis, A, Rasmussen, D B, Jensen, M T, Kragholm, K, Rossi, F, Capuano, A & Sportiello, L 2018, ' Comparison of long-term clinical implications of beta-blockade in patients with obstructive airway diseases exposed to beta-blockers with different β1-adrenoreceptor selectivity : An Italian Population-Based Cohort Study ', Frontiers in Pharmacology, vol. 9, 1212, pp. 1212 . https://doi.org/10.3389/fphar.2018.01212
Sessa, M, Mascolo, A, Scavone, C, Perone, I, Giorgio, A D, Tari, M, Fucile, A, De Angelis, A, Rasmussen, D B, Jensen, M T, Kragholm, K, Rossi, F, Capuano, A & Sportiello, L 2018, ' Comparison of long-term clinical implications of beta-blockade in patients with obstructive airway diseases exposed to beta-blockers with different β1-adrenoreceptor selectivity : An Italian population-based cohort study ', Frontiers in Pharmacology, vol. 9, 1212, pp. 1-8 . https://doi.org/10.3389/fphar.2018.01212
Frontiers in Pharmacology, Vol 9 (2018)
Sessa, M, Mascolo, A, Scavone, C, Perone, I, Giorgio, A D, Tari, M, Fucile, A, De Angelis, A, Rasmussen, D B, Jensen, M T, Kragholm, K, Rossi, F, Capuano, A & Sportiello, L 2018, ' Comparison of long-term clinical implications of beta-blockade in patients with obstructive airway diseases exposed to beta-blockers with different β1-adrenoreceptor selectivity : An Italian population-based cohort study ', Frontiers in Pharmacology, vol. 9, 1212 . https://doi.org/10.3389/fphar.2018.01212
Frontiers in Pharmacology
ISSN: 1663-9812
DOI: 10.3389/fphar.2018.01212
Popis: Rationale: Long-term clinical implications of beta-blockade in obstructive airway diseases remains controversial. We investigated if within the first 5 years of treatment patients with heart failure and obstructive airway diseases using non β1-adrenoreceptor selective beta-blockers have an increased risk of being hospitalized for all-causes, heart failure, and chronic obstructive pulmonary disease (COPD) when compared to patient using selective beta-blockers. Methods: Carvedilol users were propensity matched 1:1 for co-treatments, age, gender, and year of inclusion in the cohort with metoprolol/bisoprolol/nebivolol users. Cox proportional hazard regression model was used to compare all causes, COPD, and heart failure hospitalization or the beta-blocker discontinuation between cohorts. For statistically significant associations, we computed the rate difference and the attributable risk. Results: Overall, 11,844 patients out of the 51,214 (23.1%) were exposed to carvedilol and 39,370 (76.9%) to metoprolol/bisoprolol/nebivolol. Carvedilol users had a higher hazard for heart failure hospitalization (HR 1.29; 95% Confidence Interval [CI] 1.18–1.40) with 106 (95%CI 76–134; p-value < 0.001) additional cases of heart failure hospitalization per 10000 person-years if compared to metoprolol/bisoprolol/nebivolol users. In all, 26.8% (95%CI 22.5–30.9%; p-value < 0.001) of heart failure hospitalizations in the study population could be attributed to being exposed to carvedilol. Carvedilol users had a higher hazard (HR 1.06; 95%CI 1.02–1.10) of discontinuing the pharmacological treatment with 131 (95%CI 62–201; p-value < 0.001) additional cases of beta-blocker discontinuation per 10000 person-years metoprolol/bisoprolol/nebivolol users. In all, 6.5% (95%CI 3.9–9.0%; p-value < 0.001) of beta-blocker discontinuation could be attributed to being exposed to carvedilol. Conclusion: On long-term follow-up period, carvedilol was associated with a higher risk of heart failure hospitalization and discontinuation if compared to metoprolol/bisoprolol/nebivolol users among patients with heart failure and obstructive airway diseases.
Databáze: OpenAIRE
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