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2017 ; 19
(6
): 800-808
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Effects of ?-blockers on all-cause mortality in patients with type 2 diabetes and
coronary heart disease
#MMPMID28094466
Tsujimoto T
; Sugiyama T
; Kajio H
Diabetes Obes Metab
2017[Jun]; 19
(6
): 800-808
PMID28094466
show ga
AIMS: To assess whether the use of beta-blockers influences mortality and the
incidence of major cardiovascular events in patients with diabetes and coronary
heart disease (CHD). MATERIALS AND METHODS: Using data from the Bypass
Angioplasty Revascularization Investigation 2 Diabetes trial, we performed Cox
proportional hazards analysis to assess the effects of ?-blockers on all-cause
mortality in 2244 patients with type 2 diabetes who had stable CHD with and
without a history of myocardial infarction (MI)/heart failure with reduced left
ventricular ejection fraction (HFrEF). RESULTS: All-cause mortality in patients
with MI/HFrEF was significantly lower in those receiving ?-blockers than in those
not receiving ?-blockers (adjusted hazard ratio [HR] 0.60, 95% confidence
interval [CI] 0.37-0.98; P ?=?.04), whereas that in patients without MI/HFrEF did
not significantly differ (adjusted HR 0.91, 95% CI 0.76-1.32; P ?=?.64). Among
patients with MI/HFrEF, all-cause mortality in those who received intensive
medical therapy alone for CHD was significantly lower in those on ?-blockers than
in those not on ?-blockers (adjusted HR 0.45, 95% CI 0.23-0.88; P ?=?.02);
however, mortality in patients who received early revascularization for CHD was
not significantly lower in those on ?-blockers (adjusted HR 0.81, 95% CI
0.40-1.65; P ?=?.57). The risk of major cardiovascular events in patients without
MI/HFrEF was not significantly different between those on and those not on
?-blocker treatment. CONCLUSIONS: In patients with diabetes and CHD, the use of
?-blockers was effective in reducing all-cause mortality in those with MI/HFrEF
but not in those without MI/HFrEF.
|Adrenergic beta-Antagonists/*therapeutic use
[MESH]