Document Detail

Population-Based Analysis of Class Effect of β Blockers in Heart Failure.
MedLine Citation:
PMID:  21349489     Owner:  NLM     Status:  Publisher    
The long-term use of β blockers has been shown to improve the outcomes of patients with heart failure (HF). However, it is still disputed whether this is a class effect, and, specifically, whether carvedilol or bisoprolol are superior to metoprolol. The present study was a comparative effectiveness study of β blockers for patients with HF in a population-based setting. We conducted an observational cohort study using the Quebec administrative databases to identify patients with HF who were prescribed a β blocker after the diagnosis of HF. We used descriptive statistics to characterize the patients by the type of β blocker prescribed at discharge. The unadjusted mortality for users of each β blocker was calculated using Kaplan-Meier curves and compared using the log-rank test. To account for differences in follow-up and to control for differences among patient characteristics, a multivariate Cox proportional hazards model was used to compare the mortality. Of the 26,787 patients with HF, with a median follow-up of 1.8 years per patient, the crude incidence of death was 47% with metoprolol, 40% with atenolol, 41% with carvedilol, 36% with bisoprolol, and 43% with acebutolol. After controlling for several different covariates, we found that carvedilol (hazard ratio [HR] 1.04, 95% confidence interval [CI] 0.97 to 1.12, p = 0.22) and bisoprolol (HR 0.96, 95% CI 0.91 to 1.01, p = 0.16) were not superior to metoprolol in improving survival. Atenolol (HR 0.82, 95% CI 0.77 to 0.87, p <0.0001) and acebutolol (HR 0.86, 95% CI 0.78 to 0.95, p = 0.004) were superior to metoprolol. In conclusion, we did not find evidence of a class effect for β blockers in patients with HF.
Darius Lucian Lazarus; Cynthia Anne Jackevicius; Hassan Behlouli; Helen Johansen; Louise Pilote
Related Documents :
25261939 - The number of mechanically ventilated icu patients meeting communication criteria.
21129179 - A randomised controlled trial of patient led training in medical education: protocol.
21472149 - Triple therapy: boon or bane for high-risk cv patients?
21470399 - Opt-out as an acceptable method of obtaining consent in medical research: a short report.
3166919 - Pulmonary epithelial permeability in bronchiectasis.
20730259 - Congenital heart diseases in a reference service: clinical evolution and associated ill...
25171259 - Neuropsychiatric and seizure outcomes in nonparaneoplastic autoimmune limbic encephalitis.
22663969 - Brain dysfunction in patients with chronic critical illness.
22541679 - Successful treatment of life threatening theophylline intoxication in a pregnant patien...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-22
Journal Detail:
Title:  The American journal of cardiology     Volume:  -     ISSN:  1879-1913     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Center, McGill University, Montreal, Quebec, Canada.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

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

Previous Document:  Relation of vitamin D level to maximal oxygen uptake in adults.
Next Document:  Blood protein profiles of infants born before 28th weeks differ by pregnancy complication.