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
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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. / 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.
I: Frontiers in Pharmacology, Bind 9, 1212, 2018, s. 1-8.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Comparison of long-term clinical implications of beta-blockade in patients with obstructive airway diseases exposed to beta-blockers with different β1-adrenoreceptor selectivity
T2 - An Italian population-based cohort study
AU - Sessa, Maurizio
AU - Mascolo, Annamaria
AU - Scavone, Cristina
AU - Perone, Ilaria
AU - Giorgio, Annalisa Di
AU - Tari, Michele
AU - Fucile, Annamaria
AU - De Angelis, Antonella
AU - Rasmussen, Daniel Bech
AU - Jensen, Magnus Thorsten
AU - Kragholm, Kristian
AU - Rossi, Francesco
AU - Capuano, Annalisa
AU - Sportiello, Liberata
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
KW - Beta-blockers
KW - Clinical epidemiology
KW - Heart failure
KW - Humans
KW - Obstructive respiratory diseases
KW - Pharmacoepidemiology
KW - Pharmacology
U2 - 10.3389/fphar.2018.01212
DO - 10.3389/fphar.2018.01212
M3 - Journal article
C2 - 30459608
AN - SCOPUS:85055795890
VL - 9
SP - 1
EP - 8
JO - Frontiers in Pharmacology
JF - Frontiers in Pharmacology
SN - 1663-9812
M1 - 1212
ER -
ID: 210916922