Document Detail


Beta-blocker prescription among Japanese cardiologists and its effect on various outcomes.
MedLine Citation:
PMID:  20234099     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Beta-blockers are underprescribed for coronary artery disease (CAD) patients in Japan. Considering the vast amount of evidence showing their benefits in this group of patients, the aim of the present study was to investigate the use of beta-blockers in a large cohort of CAD patients.
METHODS AND RESULTS: The 13,812 patients with angiographically confirmed CAD were followed up for 2.7 years. From this group, 4,160 (30.1%) patients were prescribed beta-blockers at the time of discharge. These patients were significantly more likely to have hypertension, hyperlipidemia, obesity, a family history of ischemic diseases and a higher number of diseased arteries. The rate of continuation for beta-blockers was 90.8%. A propensity score matching analysis showed no additional benefits of beta-blockers in reducing all-cause mortality, cardiac events and cerebrovascular events. Lipophilic beta-blockers were significantly more effective than hydrophilic ones in reducing all-cause mortality (hazard ratio 0.467, 95% confidence interval 0.247-0.880, P=0.019).
CONCLUSIONS: Despite the low prescription rate of beta-blockers for CAD patients among Japanese physicians, the continuation rate was relatively high. Lipophilic beta-blockers may be a better choice than hydrophilic beta-blockers in terms of mortality risk, although a randomized control study would need to be conducted to verify this assertion.
Authors:
Takahide Kohro; Dobun Hayashi; Tsutomu Yamazaki; Ryozo Nagai;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-03-17
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-08-13     Revised Date:  2011-02-18    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  962-9     Citation Subset:  IM    
Affiliation:
Department of Translational Research for Healthcare and Clinical Science, The University of Tokyo, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / administration & dosage*
Aged
Asian Continental Ancestry Group
Cardiology / methods,  trends
Coronary Artery Disease / drug therapy*,  mortality
Drug Prescriptions*
Female
Follow-Up Studies
Humans
Hyperlipidemias / drug therapy,  mortality
Hypertension / drug therapy,  mortality
Japan / epidemiology
Male
Middle Aged
Myocardial Ischemia / drug therapy,  mortality
Obesity / drug therapy,  mortality
Propensity Score
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists
Comments/Corrections
Comment In:
Circ J. 2010 May;74(5):848-9   [PMID:  20424330 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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