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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Beta-blockers for coronary heart disease in chronic kidney disease

Michel Chonchol1, Michal Benderly, Uri Goldbourt

  • 1Division of Renal Diseases and Hypertension, University of Colorado Health Sciences Center, Box C-281, Denver, CO 80262, USA. Michel.Chonchol@uchsc.edu

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|January 12, 2008
PubMed

Insights

Beta-blockers offer cardioprotective benefits in coronary heart disease patients, irrespective of chronic kidney disease (CKD) status. This study found similar risk reduction for major adverse cardiac events in patients with or without CKD when treated with beta-blockers.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Limited data exist on the interaction between beta-blocker therapy and chronic kidney disease (CKD) regarding cardiovascular outcomes.
  • Investigating this relationship is crucial for optimizing treatment strategies in patients with coronary heart disease (CHD) and varying degrees of renal function.

Purpose of the Study:

  • To determine if the cardioprotective effects of beta-blockers are modified by the presence of chronic kidney disease (CKD) in patients with coronary heart disease (CHD).

Main Methods:

  • A post hoc analysis of the Bezafibrate Infarction Prevention (BIP) study cohort was conducted.
  • Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (GFR) <60 mL/min/1.73 m(2) using the MDRD equation.
  • Cox proportional hazard models, adjusted for propensity score, were used to assess the risk of acute myocardial infarction (AMI) or sudden cardiac death (SCD).

Main Results:

  • The study included 3075 CHD patients, with 18.5% having CKD. Of these, 43.1% received beta-blockers.
  • After a median follow-up of 6.2 years, the adjusted hazard ratio (HR) for AMI or SCD was 0.87 (90% CI 0.71-1.06) for beta-blocker users without CKD, and 1.35 (90% CI 1.05-1.73) for non-users with CKD.
  • Patients with both beta-blocker use and CKD had an adjusted HR of 1.06 (90% CI 0.76-1.46) compared to those without beta-blockers and without CKD.

Conclusions:

  • Beta-blocker use appears to be associated with a reduced risk of major adverse cardiac events in patients with coronary heart disease (CHD).
  • This cardioprotective association was observed consistently, regardless of whether patients had chronic kidney disease (CKD) or not.
  • The findings suggest that beta-blockers remain a valuable therapeutic option for CHD patients with impaired renal function.
Abstract

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