Carvedilol Compared With Metoprolol on Left Ventricular Ejection Fraction After Coronary Artery Bypass Graft

Shahzamani, Mehran; Ghanavati, Arash; Froutagheh, Azam Nouri; Foroughi, Mahnoosh; Rahimian, Hosein; Shahsanaei, Azadeh; Hasantash, Seyed Ahmad; Dabbagh, Ali

doi:10.1016/j.jopan.2011.09.005

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…To elucidate this problem, we next assessed the association between β-blocker use and death from any cause among confirmed COPD patients. The adjusted data confirmed that β-blocker use was not associated with all-cause mortality in elderly male COPD patients, which was consistent with the results of studies that described the beneficial effects of β-blocker use in COPD patients 26,27. An observational study suggested that β-blocker use had a tendency to lower mortality risk in patients with combined COPD and hypertension 28.…”

Section: Discussionsupporting

confidence: 86%

“…One showed that carvedilol administration had no influence on plasma NT pro-BNP levels in patients with HF 26. In the other study, β-blocker use was associated with increasing LVEF in patients undergoing coronary artery bypass grafting 27. However, neither reported an association in COPD patients, especially in high-risk patients, such as the elderly or those with multiple comorbidities for whom physicians may be hesitant to prescribe β-blockers.…”

Section: Discussionmentioning

confidence: 94%

“…Two randomized clinical trials showed a relationship between β-blocker use and cardiac function 26,27. One showed that carvedilol administration had no influence on plasma NT pro-BNP levels in patients with HF 26.…”

Section: Discussionmentioning

confidence: 99%

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Impact of beta2-agonists, beta-blockers, and their combination on cardiac function in elderly male patients with chronic obstructive pulmonary disease

Zeng

Hu²,

Liu³

et al. 2013

CIA

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PurposeThis study was undertaken to determine the association between cardiac function and therapy with beta2-adrenoceptor agonists (β2-agonists), β-blockers, or β-blocker–β-agonist combination therapy in elderly male patients with chronic obstructive pulmonary disease (COPD).Patients and methodsThis was a retrospective cohort study of 220 elderly male COPD patients (mean age 84.1 ± 6.9 years). The patients were divided into four groups on the basis of the use of β-blockers and β2-agonists. N-terminal fragment pro-B-type natriuretic peptide (NT pro-BNP), left ventricular ejection fraction (LVEF), and other relevant parameters were measured and recorded. At follow-up, the primary end point was all-cause mortality.ResultsMultiple linear regression analysis revealed no significant associations between NT pro-BNP and the use of β2-agonists (β = 35.502, P = 0.905), β-blockers (β = 3.533, P = 0.989), or combination therapy (β = 298.635, P = 0.325). LVEF was not significantly associated with the use of β2-agonists (β = −0.360, P = 0.475), β-blockers (β = −0.411, P = 0.284), or combination therapy (β = −0.397, P = 0.435). Over the follow-up period, 52 patients died, but there was no significant difference in mortality among the four groups (P = 0.357). Kaplan–Meier analysis showed no significant difference among the study groups (log-rank test, P = 0.362). After further multivariate adjustment, use of β2-agonists (hazard ratio [HR] 0.711, 95% confidence interval [CI] 0.287–1.759; P = 0.460), β-blockers (HR 0.962, 95% CI 0.405–2.285; P = 0.930), or combination therapy (HR 0.638, 95% CI 0.241–1.689; P < 0.366) were likewise not correlated with mortality.ConclusionThere was no association between the use of β2-agonists, β-blockers, or β-blocker-β2-agonist combination therapy with cardiac function and all-cause mortality in elderly male COPD patients, which indicated that they may be used safely in this population.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 94%