Liao KM, et al. – The outcome of different β–blockers in patients with concurrent congestive heart failure (CHF) and COPD were compared in this study. The results indicated that β–blockers decreased mortality, CHF exacerbation, and the need for hospitalization in patients with concurrent CHF and COPD. In addition, bisoprolol was found to lessen mortality and CHF exacerbation compared to carvedilol and metoprolol.

Methods

• A retrospective cohort study was conducted using the National Health Insurance Research Database in Taiwan.
• Patients who were >20 years old and were diagnosed with CHF between January 1, 2005 and December 31, 2012 were the inclusion criteria for CHF.
• COPD patients incorporated the individuals who had outpatient visit claims ≥2 times within 365 days or 1 claim for hospitalization with a COPD diagnosis.
• A time-dependent Cox proportional hazards regression model was applied to assess the viability of β-blockers in the study population.

Results

• 1,872 patients were identified with concurrent CHF and COPD.
• Researchers reported that only high-dose bisoprolol significantly lessened the risk of death and slightly diminished the hospitalization rate due to CHF exacerbation (death: adjusted hazard ratio [aHR] =0.51, 95% confidence interval [CI] =0.29–0.89; hospitalization rate due to CHF exacerbation: aHR =0.48, 95% CI =0.23–1.00).
• They did not find association between β-blocker use and COPD exacerbation.