Beta-blocker therapy in patients with left ventricular systolic dysfunction and chronic obstructive lung disease in an ambulatory care setting

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Autor principal: Jennifer J. SCHIMMER
Formato: Artículo científico
Lenguaje:en
Publicado: Centro de investigaciones y Publicaciones Farmacéuticas 2009
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author Jennifer J. SCHIMMER
author_facet Jennifer J. SCHIMMER
contents Beta-blocker therapy in patients with left ventricular systolic dysfunction and chronic obstructive lung disease in an ambulatory care setting Jennifer J. SCHIMMER Sarah J. BILLUPS Thomas DELATE Medicina Antagonists Heart Failure United States Adrenergic beta Pulmonary Disease Objective: To evaluate beta blocker persistence six months after beta-blocker initiation or dose titration in heart failure (HF) patients with COPD compared to those without COPD. Secondary objectives included comparison of beta-blocker dose achieved, changes in left ventricular ejection fraction (LVEF) and incidence of hospitalizations or emergency department (ED) visits during follow-up. Methods: We conducted a matched, retrospective, cohort study including 86 patients with COPD plus concomitant HF (LVEF <40%) and 137 patients with HF alone. All patients were followed in an outpatient HF clinic. Eligible patients had a documented LVEF <40% and were initiated or titrated on a beta-blocker in the HF clinic. Patients were matched based on LVEF (categorized as < 20% or 21-40%), gender, and age (> or <70 years). The primary outcome was beta blocker persistence at 6 months. Secondary outcomes were dose achieved, LVEF, and incidence of hospitalizations or ED visits. Results: There were no differences between the COPD and non-COPD groups in beta-blocker persistence at six-month follow-up (94.2% vs. 93.4% respectively, adjusted p=0.842). The proportion of patients who achieved a daily metoprolol dose equivalent of at least 100 mg was similar between the groups (adjusted in the six-month post-titration period was substantial but similar between the groups (53.5% and 48.2% for COPD and non-COPD patients, respectively, adjusted p=0.169). Conclusion: Our results support the use of beta-blockers in the population of heart failure patients with COPD and without reactive airway disease. 2009 artículo científico 1885-642X https://www.redalyc.org/articulo.oa?id=69015283003 en http://www.redalyc.org/revista.oa?id=690 Pharmacy Practice application/pdf Centro de investigaciones y Publicaciones Farmacéuticas Pharmacy Practice (España) Num.4 Vol.7
format Artículo científico
id redalyc_69015283003
institution Redalyc
language en
publishDate 2009
publisher Centro de investigaciones y Publicaciones Farmacéuticas
spellingShingle Beta-blocker therapy in patients with left ventricular systolic dysfunction and chronic obstructive lung disease in an ambulatory care setting
Jennifer J. SCHIMMER
Medicina
Antagonists
Heart Failure
United States
Adrenergic beta
Pulmonary Disease
Beta-blocker therapy in patients with left ventricular systolic dysfunction and chronic obstructive lung disease in an ambulatory care setting Jennifer J. SCHIMMER Sarah J. BILLUPS Thomas DELATE Medicina Antagonists Heart Failure United States Adrenergic beta Pulmonary Disease Objective: To evaluate beta blocker persistence six months after beta-blocker initiation or dose titration in heart failure (HF) patients with COPD compared to those without COPD. Secondary objectives included comparison of beta-blocker dose achieved, changes in left ventricular ejection fraction (LVEF) and incidence of hospitalizations or emergency department (ED) visits during follow-up. Methods: We conducted a matched, retrospective, cohort study including 86 patients with COPD plus concomitant HF (LVEF <40%) and 137 patients with HF alone. All patients were followed in an outpatient HF clinic. Eligible patients had a documented LVEF <40% and were initiated or titrated on a beta-blocker in the HF clinic. Patients were matched based on LVEF (categorized as < 20% or 21-40%), gender, and age (> or <70 years). The primary outcome was beta blocker persistence at 6 months. Secondary outcomes were dose achieved, LVEF, and incidence of hospitalizations or ED visits. Results: There were no differences between the COPD and non-COPD groups in beta-blocker persistence at six-month follow-up (94.2% vs. 93.4% respectively, adjusted p=0.842). The proportion of patients who achieved a daily metoprolol dose equivalent of at least 100 mg was similar between the groups (adjusted in the six-month post-titration period was substantial but similar between the groups (53.5% and 48.2% for COPD and non-COPD patients, respectively, adjusted p=0.169). Conclusion: Our results support the use of beta-blockers in the population of heart failure patients with COPD and without reactive airway disease. 2009 artículo científico 1885-642X https://www.redalyc.org/articulo.oa?id=69015283003 en http://www.redalyc.org/revista.oa?id=690 Pharmacy Practice application/pdf Centro de investigaciones y Publicaciones Farmacéuticas Pharmacy Practice (España) Num.4 Vol.7
title Beta-blocker therapy in patients with left ventricular systolic dysfunction and chronic obstructive lung disease in an ambulatory care setting
topic Medicina
Antagonists
Heart Failure
United States
Adrenergic beta
Pulmonary Disease
url https://www.redalyc.org/articulo.oa?id=69015283003