Document Detail

beta-Blocker use in long-term dialysis patients: association with hospitalized heart failure and mortality.
MedLine Citation:
PMID:  15596637     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: beta-Blockers have been shown to be beneficial in the treatment and prevention of heart failure (HF) in the general population, but they have not been assessed for their association with nonfatal HF in a nationally representative population of long-term dialysis patients. METHODS: We conducted a retrospective cohort study of 2550 patients enrolled in the US Renal Data System (USRDS) Wave 2 who were Medicare eligible at the start of the study. Analysis was stratified by the presence or absence of a known diagnosis of HF, and patients followed up until December 31, 2000. Cox regression analysis, including propensity scores, was used to model adjusted hazard ratios for beta-blocker use (assessed separately by cardioselective activity and lipid solubility) with time to the first Medicare institutional claim for HF, cardiovascular-related death, or death from any cause. RESULTS: In patients without a previous history of HF, beta-blocker use was significantly associated with a lower adjusted risk of HF (adjusted hazard ratio, 0.69; 95% confidence interval, 0.52-0.91; P=.008), with a similar reduction in risk of cardiac-related and all-cause death. beta-Blocker use had no statistically significant associations with outcomes in patients with previous HF. CONCLUSIONS: In dialysis patients without a previous documented history of HF, beta-blocker use was associated with a lower risk of new HF, cardiovascular death, and death from any cause. No such associations were seen for dialysis patients with a previous history of HF. These results are hypothesis generating only and should be confirmed in randomized trials.
Kevin C Abbott; Fernando C Trespalacios; Lawrence Y Agodoa; Allen J Taylor; George L Bakris
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of internal medicine     Volume:  164     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:    2004 Dec 13-27
Date Detail:
Created Date:  2004-12-14     Completed Date:  2005-01-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2465-71     Citation Subset:  AIM; IM    
Nephrology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use*
Cohort Studies
Heart Failure / complications,  mortality,  prevention & control*
Kidney Failure, Chronic / complications,  drug therapy
Middle Aged
Regression Analysis
Renal Dialysis*
Retrospective Studies
Reg. No./Substance:
0/Adrenergic beta-Antagonists

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

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