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Titolo:
Effectiveness of beta-blocker therapy after acute myocardial infarction inelderly patients with chronic obstructive pulmonary disease or asthma
Autore:
Chen, J; Radford, MJ; Wang, Y; Marciniak, TA; Krumholz, HM;
Indirizzi:
Yale Univ, Sch Med, Dept Med, Sect Cardiovasc Med, New Haven, CT 06510 USAYale Univ New Haven CT USA 06510 Cardiovasc Med, New Haven, CT 06510 USA Yale New Haven Hosp, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA Yale New Haven Hosp New Haven CT USA 06504 aluat, New Haven, CT 06504 USA Qualidigm, Middletown, CT USA Qualidigm Middletown CT USAQualidigm, Middletown, CT USA US Hlth Care Financing Adm, Baltimore, MD 21207 USA US Hlth Care FinancingAdm Baltimore MD USA 21207 Baltimore, MD 21207 USA Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, Sect Hlth Policy & Adm, New Haven, CT 06510 USA Yale Univ New Haven CT USA 06510 th Policy & Adm, New Haven, CT 06510 USA
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 7, volume: 37, anno: 2001,
pagine: 1950 - 1956
SICI:
0735-1097(20010601)37:7<1950:EOBTAA>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
COOPERATIVE CARDIOVASCULAR PROJECT; RANDOMIZED TRIALS; INDIVIDUAL PATIENTS; MORTALITY; MEDICARE; DRUGS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Krumholz, HM 333 Cedar St,POB 208025, New Haven, CT 06520 USA 333 Cedar St,POB 208025 New Haven CT USA 06520 CT 06520 USA
Citazione:
J. Chen et al., "Effectiveness of beta-blocker therapy after acute myocardial infarction inelderly patients with chronic obstructive pulmonary disease or asthma", J AM COL C, 37(7), 2001, pp. 1950-1956

Abstract

OBJECTIVES We evaluated the use and effectiveness of beta-blocker therapy after acute myocardial infarction (AMI) for elderly patients with chronic obstructive pulmonary disease (COPD) or asthma. BACKGROUND Because patients with COPD and asthma have largely been excluded from clinical trials of beta-blocker therapy for AMI, the extent to whichthese patients would benefit from beta-blocker therapy after AMI is not well defined. METHODS Using data from the Cooperative Cardiovascular Project, we examined the relationship between discharge use of beta-blockers and one-year mortality in patients with COPD or asthma who were not using beta-agonists, patients with COPD or asthma who were concurrently using beta-agonists and patients with evidence of severe disease (use of prednisone or previous hospitalization for COPD or asthma) compared with patients without COPD or asthma. RESULTS Of 54,962 patients without contraindications to beta-blockers, patients with COPD or asthma (20%) were significantly less likely to be prescribed beta-blockers at discharge after AMI. After adjusting for demographic and clinical factors, we found that beta-blockers were associated with lower one-year mortality in patients with COPD or asthma who were not on beta-agonist therapy (relative risk [RR] = 0.85, 95% confidence interval [CI] 0.73 to 1.00), similar to patients without COPD or asthma (RR = 0.86, 95% CI 0.81 to 0.92). A survival benefit for beta-blockers was not found among patients concurrently using beta-agonists or with severe COPD or asthma. CONCLUSIONS Beta-blocker therapy after AMI may be beneficial for CORD or asthma patients with mild disease. A survival benefit was not found for elderly AMI patients with more severe pulmonary disease. (J Am Coll Cardiol 2001;37:1950-6) (C) 2001 by the American College of Cardiology.

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Documento generato il 01/12/20 alle ore 19:59:08