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Use of beta-blocker is associated with lower mortality in patients with coronary artery disease with or without COPD
Safoura Sheikh Rezaei1, Christoph Rinner2, Paulina Ratajczak2
1Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Insights
Beta-blockers are crucial for coronary artery disease (CAD) secondary prevention. This study found similar beta-blocker use in CAD patients with or without chronic obstructive pulmonary disease (COPD), with lower mortality rates for users in both groups.
Area of Science:
- Cardiology
- Pulmonology
- Pharmacology
Background:
- Beta-blockers are vital for secondary prevention in coronary artery disease (CAD).
- Underuse of beta-blockers has been noted in patients with co-existing chronic obstructive pulmonary disease (COPD).
Purpose of the Study:
- To investigate beta-blocker utilization and its impact on mortality in patients with CAD, with or without COPD.
- To compare beta-blocker use and outcomes between CAD patients who have COPD and those who do not.
Main Methods:
- Analysis of prescription, demographic, and hospital discharge data from Austrian health insurance funds (2006-2007).
- Inclusion of 65,717 patients diagnosed with CAD.
- Primary endpoint: all-cause mortality associated with beta-blocker use in CAD patients with and without COPD.
Main Results:
- Beta-blocker use was comparable between CAD patients with (77%) and without (74%) COPD.
- Mortality rates were significantly lower for beta-blocker users compared to non-users in both CAD patient groups (8.1% vs 22.0% with COPD, 5.6% vs 22.2% without COPD).
Conclusions:
- Beta-blocker prescription rates are similar for CAD patients with or without COPD.
- Beta-blocker use is associated with markedly reduced mortality in CAD patients, irrespective of COPD co-morbidity.
Introduction:
Beta-blockers are indicated for secondary prevention of coronary artery disease (CAD). However, in patients with co-morbidity of chronic obstructive pulmonary disease (COPD) an underuse of beta-blocker has been reported.
Materials And Methods:
Prescription and demographic data and information on hospital discharge diagnoses from 13 Austrian health insurance funds for the years 2006-2007 were analyzed. The primary end point was all-cause mortality of patients with CAD with or without COPD and its association with use of beta-blockers.
Results:
In 2006 and 2007, 65717 patients (37% female, 63% male) were discharged with a diagnosis of CAD. Among these patients, 46% had a co-diagnosis of COPD, 24% had diabetes, and 75% received beta-blockers. Use of beta-blockers was comparable in CAD patients with COPD and without COPD with 77% and 74%, respectively. Thousand eight hundred seventy-two (8.1%) and 1473 (5.6%) patients with and without COPD, who used beta-blockers died within months in 2006 and 2007. Thousand five hundred fifty-three (22.0%) and 1862 (22.2%) of patients with and without COPD and without beta-blockers died during the corresponding time period.
Discussion:
Use of beta-blockers was similar in patients with CAD with or without co-diagnosis of COPD. However, mortality of beta-blocker users was markedly lower than that of nonusers in patients with CAD with or without COPD.
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