Comparison of the clinical outcome of different beta-blockers in heart failure patients: a retrospective nationwide cohort study
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Comparison of the clinical outcome of different beta-blockers in heart failure patients : a retrospective nationwide cohort study. / Bølling, Rasmus; Scheller, Nikolai Madrid; Køber, Lars; Poulsen, Henrik Enghusen; Gislason, Gunnar H; Torp-Pedersen, Christian.
In: European Journal of Heart Failure, Vol. 16, No. 6, 06.2014, p. 678-684.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Comparison of the clinical outcome of different beta-blockers in heart failure patients
T2 - a retrospective nationwide cohort study
AU - Bølling, Rasmus
AU - Scheller, Nikolai Madrid
AU - Køber, Lars
AU - Poulsen, Henrik Enghusen
AU - Gislason, Gunnar H
AU - Torp-Pedersen, Christian
N1 - © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.
PY - 2014/6
Y1 - 2014/6
N2 - AIM: To compare survival on different beta-blockers in heart failure.METHODS AND RESULTS: We identified all Danish patients ≥35 years of age who were hospitalized with a first admission for heart failure and who initiated treatment with a beta-blocker within 60 days of discharge. The study period was 1995-2011. The main outcome was all-cause mortality and all-cause hospitalization. Cox proportional hazard models were used to compare survival. The study included 58 634 patients of whom 30.121 (51.4%) died and 46.990 (80.1%) were hospitalized during follow-up. The mean follow-up time was 4.1 years. In an unadjusted model carvedilol was associated with a lower mortality [hazard ratio (HR) 0.737, 0.714-0.761] compared with metoprolol (reference) while bisoprolol was not associated with an increased mortality (HR 1.020, 0.973-1.069). In a model adjusted for possible confounders and stratified according to beta-blocker dosages, patients that received high-dose carvedilol (≥50 mg daily) had a lower all-cause mortality risk (HR 0.873, 0.789-0.966) than patients receiving high-dose (≥200 mg daily) metoprolol (reference). High-dose bisoprolol (≥10 mg daily) was associated with a greater risk of death (HR 1.125, 1.004-1.261). High-dose carvedilol was associated with significantly lower all-cause hospitalization risk (HR 0.842, 0.774-0.915) than high-dose metoprolol (reference), while high-dose bisoprolol had insignificantly lower risk than high-dose metoprolol (HR 0.948, 0.850-1.057).CONCLUSIONS: Heart failure patients receiving high-dose carvedilol (≥50 mg daily) showed significantly lower all-cause mortality risk and hospitalization risk, compared with other beta-blockers.
AB - AIM: To compare survival on different beta-blockers in heart failure.METHODS AND RESULTS: We identified all Danish patients ≥35 years of age who were hospitalized with a first admission for heart failure and who initiated treatment with a beta-blocker within 60 days of discharge. The study period was 1995-2011. The main outcome was all-cause mortality and all-cause hospitalization. Cox proportional hazard models were used to compare survival. The study included 58 634 patients of whom 30.121 (51.4%) died and 46.990 (80.1%) were hospitalized during follow-up. The mean follow-up time was 4.1 years. In an unadjusted model carvedilol was associated with a lower mortality [hazard ratio (HR) 0.737, 0.714-0.761] compared with metoprolol (reference) while bisoprolol was not associated with an increased mortality (HR 1.020, 0.973-1.069). In a model adjusted for possible confounders and stratified according to beta-blocker dosages, patients that received high-dose carvedilol (≥50 mg daily) had a lower all-cause mortality risk (HR 0.873, 0.789-0.966) than patients receiving high-dose (≥200 mg daily) metoprolol (reference). High-dose bisoprolol (≥10 mg daily) was associated with a greater risk of death (HR 1.125, 1.004-1.261). High-dose carvedilol was associated with significantly lower all-cause hospitalization risk (HR 0.842, 0.774-0.915) than high-dose metoprolol (reference), while high-dose bisoprolol had insignificantly lower risk than high-dose metoprolol (HR 0.948, 0.850-1.057).CONCLUSIONS: Heart failure patients receiving high-dose carvedilol (≥50 mg daily) showed significantly lower all-cause mortality risk and hospitalization risk, compared with other beta-blockers.
KW - Adrenergic beta-Antagonists
KW - Aged
KW - Cohort Studies
KW - Denmark
KW - Female
KW - Follow-Up Studies
KW - Heart Failure
KW - Hospitalization
KW - Humans
KW - Male
KW - Middle Aged
KW - Proportional Hazards Models
KW - Retrospective Studies
KW - Survival Analysis
KW - Treatment Outcome
U2 - 10.1002/ejhf.81
DO - 10.1002/ejhf.81
M3 - Journal article
C2 - 24706485
VL - 16
SP - 678
EP - 684
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1567-4215
IS - 6
ER -
ID: 138613768