Evaluating the effectiveness of different beta-adrenoceptor blockers in heart failure patients

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• 作者：Tien-Yu Lin^a ; ¹ ; Chung-Yu Chen^a ; ^b ; ¹ ; ^{jk2975525@hotmail.com} ; Yaw-Bin Huang^a ; ^b ; ¹ ; ^{yabihu@kmu.edu.tw}
• 关键词：Heart failure ; beta-Blockers ; Effectiveness
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 March 2017
• 年：2017
• 卷：230
• 期：Complete
• 页码：378-383
• 全文大小：327 K
• 卷排序：230

文摘

According to guidelines and pivotal trials, β-blockers are associated with better survival in patients with heart failure (HF). However, the superiority of any β-blockers is still unclear.MethodsThis retrospective cohort study was conducted using the National Health Insurance Research Database in Taiwan to evaluate the effectiveness of β-blockers and compare the clinical outcomes of different β-blockers in patients with HF. We enrolled patients diagnosed with HF between 2005 and 2012. We then stratified the β-blockers according to the starting dose: lower in group 1 and higher in group 2. A time-dependent Cox proportional hazards regression model was applied to evaluate the effectiveness of the β-blockers.ResultsA total of 14,875 patients with HF were identified during the study period. After propensity-score matching, 5688 patients were included in both the β-blocker user and nonuser groups. We found that group 2 carvedilol and group 2 bisoprolol significantly reduced the risk of death and hospitalization for HF, whereas metoprolol did not. Compared with group 2 carvedilol, survival was not significantly different for group 2 bisoprolol (adjusted hazard ratio = 1.18, 95% confidence interval = 0.88–1.58).ConclusionFrom results, carvedilol and bisoprolol were associated with better outcomes, with no difference between these two β-blockers in patients with HF in Taiwan.