Key result
Beta-blocker use was associated with lower mortality compared to nonuse in patients with coronary artery disease, both with COPD (8.1% vs 22.0%) and without COPD (5.6% vs 22.2%).
Why the study?
Does beta-blocker use reduce all-cause mortality in patients with CAD with or without COPD?
Cohort (n=65,717)
Yes
Does beta-blocker use reduce all-cause mortality in patients with CAD with or without COPD?
Beta-blocker use is associated with markedly lower mortality in CAD patients, regardless of whether they have a co-diagnosis of COPD.
May support beta-blocker use in CAD patients with COPD; leaves open causal confirmation in prospective trials.
INTRODUCTION: Beta-blockers are indicated for secondary prevention of coronary artery disease (CAD). However, in patients with co-morbidity of chronic obstructive pulmonary disease (COPD) an underuse of beta-blocker has been reported. MATERIALS AND METHODS: Prescription and demographic data and information on hospital discharge diagnoses from 13 Austrian health insurance funds for the years 2006-2007 were analyzed. The primary end point was all-cause mortality of patients with CAD with or without COPD and its association with use of beta-blockers. RESULTS: In 2006 and 2007, 65717 patients (37% female, 63% male) were discharged with a diagnosis of CAD. Among these patients, 46% had a co-diagnosis of COPD, 24% had diabetes, and 75% received beta-blockers. Use of beta-blockers was comparable in CAD patients with COPD and without COPD with 77% and 74%, respectively. Thousand eight hundred seventy-two (8.1%) and 1473 (5.6%) patients with and without COPD, who used beta-blockers died within months in 2006 and 2007. Thousand five hundred fifty-three (22.0%) and 1862 (22.2%) of patients with and without COPD and without beta-blockers died during the corresponding time period. DISCUSSION: Use of beta-blockers was similar in patients with CAD with or without co-diagnosis of COPD. However, mortality of beta-blocker users was markedly lower than that of nonusers in patients with CAD with or without COPD.
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Rezaei et al. (2018) conducted a cohort in Coronary artery disease with or without COPD (n=65,717). Beta-blockers vs. No beta-blockers was evaluated on All-cause mortality. Beta-blocker use was associated with lower mortality compared to nonuse in patients with coronary artery disease, both with COPD (8.1% vs 22.0%) and without COPD (5.6% vs 22.2%).
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