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Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Diabetes+Obes+Metab 2017 ; 19 (6): 800-8 Nephropedia Template TP
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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): 800-8 PMID28094466show 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.