Unknown

Dataset Information

0

The association of beta-blocker use with mortality in elderly patients with congestive heart failure and advanced chronic kidney disease.


ABSTRACT: BACKGROUND:Whether the survival benefit of β-blockers in congestive heart failure (CHF) from randomized trials extends to patients with advanced chronic kidney disease (CKD) [estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 but not receiving dialysis] is uncertain. METHODS:This was a retrospective cohort study using administrative datasets. Older adults from Ontario, Canada, with incident CHF (median age 79 years) from April 2002 to March 2014 were included. We matched new users of β-blockers to nonusers on age, sex, eGFR categories (>60, 30-60, <30), CHF diagnosis date and a high-dimensional propensity score. Using Cox proportional hazards models, we examined the association of β-blocker use versus nonuse with all-cause mortality. RESULTS:We matched 5862 incident β-blocker users (eGFR >60, n = 3136; eGFR 30-60, n = 2368; eGFR <30, n = 358). There were 2361 mortality events during follow-up. β-Blocker use was associated with reduced all-cause mortality [adjusted hazard ratio (HR) 0.58, 95% confidence interval (CI) 0.54-0.64]. This result was consistent across all eGFR categories (>60: adjusted HR 0.55, 95% CI 0.49-0.62; 30-60: adjusted HR 0.63, 95% CI 0.55-0.71; <30: adjusted HR 0.55, 95% CI 0.41-0.73; interaction term, P = 0.30). The results were consistent in an intention-to-treat analysis and with β-blocker use treated as a time-varying exposure. CONCLUSIONS:β-Blocker use is associated with reduced all-cause mortality in elderly patients with CHF and CKD, including those with an eGFR <30. Randomized trials that examine β-blockers in patients with CHF and advanced CKD are needed.

SUBMITTER: Molnar AO 

PROVIDER: S-EPMC7203558 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

altmetric image

Publications

The association of beta-blocker use with mortality in elderly patients with congestive heart failure and advanced chronic kidney disease.

Molnar Amber O AO   Petrcich William W   Weir Matthew A MA   Garg Amit X AX   Walsh Michael M   Sood Manish M MM  

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 20200501 5


<h4>Background</h4>Whether the survival benefit of β-blockers in congestive heart failure (CHF) from randomized trials extends to patients with advanced chronic kidney disease (CKD) [estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 but not receiving dialysis] is uncertain.<h4>Methods</h4>This was a retrospective cohort study using administrative datasets. Older adults from Ontario, Canada, with incident CHF (median age 79 years) from April 2002 to March 2014 were included. We match  ...[more]

Similar Datasets

| S-EPMC9715887 | biostudies-literature
| S-EPMC2851851 | biostudies-literature
| S-EPMC2335176 | biostudies-literature
| S-EPMC7389334 | biostudies-literature
| S-EPMC9015092 | biostudies-literature
| S-EPMC3739581 | biostudies-other
| S-EPMC10192283 | biostudies-literature
| S-EPMC10877653 | biostudies-literature
2003-07-16 | GSE472 | GEO
2003-09-08 | GSE632 | GEO