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2016 ; 5
(1
): ä Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
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]