Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 10 » Issue 1

Impact of β-blocker selectivity on long-term outcomes in congestive heart failure patients with chronic obstructive pulmonary disease

Authors Kubota Y, Asai K, Furuse E, Nakamura S, Murai K, Tsukada YT, Shimizu W

Received 28 December 2014

Accepted for publication 10 February 2015

Published 5 March 2015 Volume 2015:10(1) Pages 515—523

DOI https://doi.org/10.2147/COPD.S79942

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Richard Russell

Yoshiaki Kubota, Kuniya Asai, Erito Furuse, Shunichi Nakamura, Koji Murai, Yayoi Tetsuou Tsukada, Wataru Shimizu

Department of Medicine (Division of Cardiology), Nippon Medical School, Bunkyo-ku, Tokyo, Japan

Background: Chronic obstructive pulmonary disease (COPD) is present in approximately one-third of all congestive heart failure (CHF) patients, and is a key cause of underprescription and underdosing of β-blockers, largely owing to concerns about precipitating respiratory deterioration. For these reasons, the aim of this study was to evaluate the impact of β-blockers on the long-term outcomes in CHF patients with COPD. In addition, we compared the effects of two different β-blockers, carvedilol and bisoprolol.
Methods: The study was a retrospective, non-randomized, single center trial. Acute decompensated HF patients with COPD were classified according to the oral drug used at discharge into β-blocker (n=86; carvedilol [n=52] or bisoprolol [n=34]) and non-β-blocker groups (n=46). The primary endpoint was all-cause mortality between the β-blocker and non-β-blocker groups during a mean clinical follow-up of 33.9 months. The secondary endpoints were the differences in all-cause mortality and the hospitalization rates for CHF and/or COPD exacerbation between patients receiving carvedilol and bisoprolol.
Results: The mortality rate was higher in patients without β-blockers compared with those taking β-blockers (log-rank P=0.039), and univariate analyses revealed that the use of β-blockers was the only factor significantly correlated with the mortality rate (hazard ratio: 0.41; 95% confidence interval: 0.17–0.99; P=0.047). Moreover, the rate of CHF and/or COPD exacerbation was higher in patients treated with carvedilol compared with bisoprolol (log-rank P=0.033). In the multivariate analysis, only a past history of COPD exacerbation significantly increased the risk of re-hospitalization due to CHF and/or COPD exacerbation (adjusted hazard ratio: 3.11; 95% confidence interval: 1.47–6.61; P=0.003).
Conclusion: These findings support the recommendations to use β-blockers in HF patients with COPD. Importantly, bisoprolol reduced the incidence of CHF and/or COPD exacerbation compared with carvedilol.

Keywords: mortality, selective β-blocker

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Other article by this author:

COPD advances in left ventricular diastolic dysfunction

Kubota Y, Asai K, Murai K, Tsukada YT, Hayashi H, Saito Y, Azuma A, Gemma A, Shimizu W

International Journal of Chronic Obstructive Pulmonary Disease 2016, 11:649-655

Published Date: 29 March 2016

Readers of this article also read:

COPD advances in left ventricular diastolic dysfunction

Kubota Y, Asai K, Murai K, Tsukada YT, Hayashi H, Saito Y, Azuma A, Gemma A, Shimizu W

International Journal of Chronic Obstructive Pulmonary Disease 2016, 11:649-655

Published Date: 29 March 2016

Neuroleptic-induced deficit syndrome in bipolar disorder with psychosis

Ueda S, Sakayori T, Omori A, Fukuta H, Kobayashi T, Ishizaka K, Saijo T, Okubo Y

Neuropsychiatric Disease and Treatment 2016, 12:265-268

Published Date: 2 February 2016

Long-term effects of gastrectomy in patients with spirometry-defined COPD and patients at risk of COPD: a case-control study

Saito H, Nomura K, Abe S, Motegi T, Ishii T, Hattori K, Kusunoki Y, Gemma A, Kida K

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:2311-2318

Published Date: 29 October 2015

Single and multiple dose pharmacokinetics and tolerability of HX-1171, a novel antioxidant, in healthy volunteers

Kim YH, Choi HY, Lee SH, Lim HS, Miki T, Kang JK, Han KG, Bae KS

Drug Design, Development and Therapy 2015, 9:1735-1742

Published Date: 23 March 2015

Presymptomatic genetic analysis during pregnancy for vascular type Ehlers–Danlos syndrome

Naing BT, Watanabe A, Tanigaki S, Ono M, Iwashita M, Shimada T

International Medical Case Reports Journal 2014, 7:99-102

Published Date: 19 June 2014

Curcumin and 5-Fluorouracil-loaded, folate- and transferrin-decorated polymeric magnetic nanoformulation: a synergistic cancer therapeutic approach, accelerated by magnetic hyperthermia

Balasubramanian S, Girija AR, Nagaoka Y, Iwai S, Suzuki M,
Kizhikkilot V, Yoshida Y, Maekawa T, Nair SD

International Journal of Nanomedicine 2014, 9:437-459

Published Date: 9 January 2014

Comparison of once daily versus twice daily olmesartan in patients with chronic kidney disease

Sakai Y, Suzuki A, Mugishima K, Sumi Y, Otsuka Y, Otsuka T, Ohno D, Murasawa T, Tsuruoka S

International Journal of Nephrology and Renovascular Disease 2013, 6:223-227

Published Date: 11 October 2013

Excessive visceral fat accumulation in advanced chronic obstructive pulmonary disease

Furutate R, Ishii T, Wakabayashi R, Motegi T, Yamada K, Gemma A, Kida K

International Journal of Chronic Obstructive Pulmonary Disease 2011, 6:423-430

Published Date: 8 August 2011

Circulating tumor cells (CTCs) in lung cancer: current status and future perspectives

Fumihiro Tanaka, Kazue Yoneda, Seiki Hasegawa

Lung Cancer: Targets and Therapy 2010, 1:77-84

Published Date: 7 July 2010