The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction
Background/Aims It is unknown whether different β-blockers (BBs) have variable effects on long-term survival of patients with heart failure with reduced ejection fraction (HFrEF). This study compares the effects of two BBs, carvedilol and bisoprolol, on survival in patients with HFrEF. Methods The K...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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The Korean Association of Internal Medicine
2019-09-01
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| Series: | The Korean Journal of Internal Medicine |
| Subjects: | |
| Online Access: | http://www.kjim.org/upload/pdf/kjim-2018-009.pdf |
| _version_ | 1818357082525532160 |
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| author | Ki Hong Choi Ga Yeon Lee Jin-Oh Choi Eun-Seok Jeon Hae-Young Lee Sang Eun Lee Jae-Joong Kim Shung Chull Chae Sang Hong Baek Seok-Min Kang Dong-Ju Choi Byung-Su Yoo Kye Hun Kim Myeong-Chan Cho Hyun-Young Park Byung-Hee Oh |
| author_facet | Ki Hong Choi Ga Yeon Lee Jin-Oh Choi Eun-Seok Jeon Hae-Young Lee Sang Eun Lee Jae-Joong Kim Shung Chull Chae Sang Hong Baek Seok-Min Kang Dong-Ju Choi Byung-Su Yoo Kye Hun Kim Myeong-Chan Cho Hyun-Young Park Byung-Hee Oh |
| author_sort | Ki Hong Choi |
| collection | DOAJ |
| description | Background/Aims It is unknown whether different β-blockers (BBs) have variable effects on long-term survival of patients with heart failure with reduced ejection fraction (HFrEF). This study compares the effects of two BBs, carvedilol and bisoprolol, on survival in patients with HFrEF. Methods The Korean Acute Heart Failure (KorAHF) registry is a prospective multicenter cohort that includes 5,625 patients who were hospitalized for acute heart failure (AHF). We selected 3,016 patients with HFrEF and divided this study population into two groups: BB at discharge (n = 1,707) or no BB at discharge (n = 1,309). Among patients with BB at discharge, subgroups were formed based on carvedilol prescription (n = 831), or bisoprolol prescription (n = 553). Propensity score matching analysis was performed. Results Among patients who were prescribed a BB at discharge, 60.5% received carvedilol and 32.7% received bisoprolol. There was a significant reduction in allcause mortality in those patients with HFrEF prescribed a BB at discharge compared to those who were not (BB vs. no BB, 26.1% vs. 40.8%; hazard ratio [HR], 0.59; 95% confidence interval [CI], 0.52 to 0.67; p < 0.001). However, there was no significant difference in the rate of all-cause mortality between those receiving different types of BB (carvedilol vs. bisoprolol, 27.5% vs. 23.5%; HR, 1.21; 95% CI, 0.99 to 1.47; p = 0.07). Similar results were observed after propensity score matching analysis (508 pairs, 26.2% vs. 23.8%; HR, 1.10; 95% CI, 0.86 to 1.40; p = 0.47). Conclusions In the treatment of AHF with reduced EF after hospitalization, mortality benefits of carvedilol and bisoprolol were comparable. |
| first_indexed | 2024-12-13T20:07:27Z |
| format | Article |
| id | doaj.art-355a72f5c5554950b0a342dda47690d1 |
| institution | Directory Open Access Journal |
| issn | 1226-3303 2005-6648 |
| language | English |
| last_indexed | 2024-12-13T20:07:27Z |
| publishDate | 2019-09-01 |
| publisher | The Korean Association of Internal Medicine |
| record_format | Article |
| series | The Korean Journal of Internal Medicine |
| spelling | doaj.art-355a72f5c5554950b0a342dda47690d12022-12-21T23:33:00ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482019-09-013451030103910.3904/kjim.2018.009170119The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fractionKi Hong Choi0Ga Yeon Lee1Jin-Oh Choi2Eun-Seok Jeon3Hae-Young Lee4Sang Eun Lee5Jae-Joong Kim6Shung Chull Chae7Sang Hong Baek8Seok-Min Kang9Dong-Ju Choi10Byung-Su Yoo11Kye Hun Kim12Myeong-Chan Cho13Hyun-Young Park14Byung-Hee Oh15 Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Heart Research Center of Chonnam National University, Gwangju, Korea Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea National Institute of Health (NIH), Osong, Korea Department of Internal Medicine, Seoul National University Hospital, Seoul, KoreaBackground/Aims It is unknown whether different β-blockers (BBs) have variable effects on long-term survival of patients with heart failure with reduced ejection fraction (HFrEF). This study compares the effects of two BBs, carvedilol and bisoprolol, on survival in patients with HFrEF. Methods The Korean Acute Heart Failure (KorAHF) registry is a prospective multicenter cohort that includes 5,625 patients who were hospitalized for acute heart failure (AHF). We selected 3,016 patients with HFrEF and divided this study population into two groups: BB at discharge (n = 1,707) or no BB at discharge (n = 1,309). Among patients with BB at discharge, subgroups were formed based on carvedilol prescription (n = 831), or bisoprolol prescription (n = 553). Propensity score matching analysis was performed. Results Among patients who were prescribed a BB at discharge, 60.5% received carvedilol and 32.7% received bisoprolol. There was a significant reduction in allcause mortality in those patients with HFrEF prescribed a BB at discharge compared to those who were not (BB vs. no BB, 26.1% vs. 40.8%; hazard ratio [HR], 0.59; 95% confidence interval [CI], 0.52 to 0.67; p < 0.001). However, there was no significant difference in the rate of all-cause mortality between those receiving different types of BB (carvedilol vs. bisoprolol, 27.5% vs. 23.5%; HR, 1.21; 95% CI, 0.99 to 1.47; p = 0.07). Similar results were observed after propensity score matching analysis (508 pairs, 26.2% vs. 23.8%; HR, 1.10; 95% CI, 0.86 to 1.40; p = 0.47). Conclusions In the treatment of AHF with reduced EF after hospitalization, mortality benefits of carvedilol and bisoprolol were comparable.http://www.kjim.org/upload/pdf/kjim-2018-009.pdfbeta-blockerheart failure with reduced ejection fractioncarvedilolbisoprolol |
| spellingShingle | Ki Hong Choi Ga Yeon Lee Jin-Oh Choi Eun-Seok Jeon Hae-Young Lee Sang Eun Lee Jae-Joong Kim Shung Chull Chae Sang Hong Baek Seok-Min Kang Dong-Ju Choi Byung-Su Yoo Kye Hun Kim Myeong-Chan Cho Hyun-Young Park Byung-Hee Oh The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction The Korean Journal of Internal Medicine beta-blocker heart failure with reduced ejection fraction carvedilol bisoprolol |
| title | The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction |
| title_full | The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction |
| title_fullStr | The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction |
| title_full_unstemmed | The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction |
| title_short | The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction |
| title_sort | mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction |
| topic | beta-blocker heart failure with reduced ejection fraction carvedilol bisoprolol |
| url | http://www.kjim.org/upload/pdf/kjim-2018-009.pdf |
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