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10.1161/JAHA.115.002584

http://scihub22266oqcxt.onion/10.1161/JAHA.115.002584
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C4859376!4859376 !26738790
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suck abstract from ncbi


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pmid26738790
      J+Am+Heart+Assoc 2016 ; 5 (1 ): ä
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  • Prognostic Benefits of Carvedilol, Bisoprolol, and Metoprolol Controlled Release/Extended Release in Hemodialysis Patients with Heart Failure: A 10-Year Cohort #MMPMID26738790
  • Tang CH ; Wang CC ; Chen TH ; Hong CY ; Sue YM
  • J Am Heart Assoc 2016[Jan]; 5 (1 ): ä PMID26738790 show ga
  • BACKGROUND: Heart failure is a highly prevalent cardiovascular complication among patients receiving long-term hemodialysis, but the benefits of carvedilol, bisoprolol, and metoprolol controlled release/extended release on the outcomes of these patients remain unclear. In this study, we address the use of these 3 ?-blockers and their associations with mortality. METHODS AND RESULTS: Long-term hemodialysis patients, aged ?35 years, with new-onset heart failure and receiving various medications were identified through the use of 1999-2010 data from the Taiwan National Health Insurance Research Database. From the total of 4435 heart failure patients, we selected 1700 new users of the 3 ?-blockers (study group) and 1700 nonusers (control group), by using matched cohorts according to their propensity scores, and then compared the 5-year all-cause mortality rates by using Cox proportional hazard regressions and time-dependent covariate adjustment. During 3944 person-years of follow-up, 666 (39.2%) deaths occurred within the study group, compared with 918 (54%) deaths during 2893 person-years of follow-up in the control group. The 5-year mortality rate for the study (control) group was 54.5% (70.3%); P<0.001. Adjusted hazard regression analyses revealed that the therapeutic effects of ?-blockers remained significant for all-cause mortality (hazard ratio 0.80, 95% CI 0.72 to 0.90). Subgroup analyses revealed that patients in the study group receiving ?-blockers plus renin-angiotensin system antagonists exhibited the lowest mortality rate, while the highest mortality rate was found among patients in the control group receiving neither ?-blockers nor renin-angiotensin system antagonists. CONCLUSIONS: This study demonstrates that the 3 ?-blockers were associated with improved survival in long-term hemodialysis patients with heart failure.
  • |*Renal Dialysis/adverse effects/mortality [MESH]
  • |Adrenergic beta-Antagonists/adverse effects/chemistry/*therapeutic use [MESH]
  • |Adult [MESH]
  • |Aged [MESH]
  • |Angiotensin II Type 1 Receptor Blockers/therapeutic use [MESH]
  • |Angiotensin-Converting Enzyme Inhibitors/therapeutic use [MESH]
  • |Bisoprolol/adverse effects/chemistry/*therapeutic use [MESH]
  • |Carbazoles/adverse effects/chemistry/*therapeutic use [MESH]
  • |Carvedilol [MESH]
  • |Chi-Square Distribution [MESH]
  • |Databases, Factual [MESH]
  • |Delayed-Action Preparations [MESH]
  • |Drug Compounding [MESH]
  • |Female [MESH]
  • |Heart Failure/diagnosis/*drug therapy/mortality [MESH]
  • |Humans [MESH]
  • |Kaplan-Meier Estimate [MESH]
  • |Kidney Failure, Chronic/diagnosis/mortality/*therapy [MESH]
  • |Male [MESH]
  • |Metoprolol/adverse effects/chemistry/*therapeutic use [MESH]
  • |Middle Aged [MESH]
  • |Multivariate Analysis [MESH]
  • |Propanolamines/adverse effects/chemistry/*therapeutic use [MESH]
  • |Propensity Score [MESH]
  • |Proportional Hazards Models [MESH]
  • |Retrospective Studies [MESH]
  • |Risk Factors [MESH]
  • |Taiwan [MESH]
  • |Time Factors [MESH]


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