Impact of beta2-agonists, beta-blockers, and their combination on cardiac function in elderly male patients with chronic obstructive pulmonary disease

Abstract

PurposeThis study was undertaken to determine the association between cardiac function and therapy with beta2-adrenoceptor agonists (β2-agonists), β-blockers, or β-blocker–β-agonist combination therapy in elderly male patients with chronic obstructive pulmonary disease (COPD).Patients and methodsThis was a retrospective cohort study of 220 elderly male COPD patients (mean age 84.1 ± 6.9 years). The patients were divided into four groups on the basis of the use of β-blockers and β2-agonists. N-terminal fragment pro-B-type natriuretic peptide (NT pro-BNP), left ventricular ejection fraction (LVEF), and other relevant parameters were measured and recorded. At follow-up, the primary end point was all-cause mortality.ResultsMultiple linear regression analysis revealed no significant associations between NT pro-BNP and the use of β2-agonists (β = 35.502, P = 0.905), β-blockers (β = 3.533, P = 0.989), or combination therapy (β = 298.635, P = 0.325). LVEF was not significantly associated with the use of β2-agonists (β = −0.360, P = 0.475), β-blockers (β = −0.411, P = 0.284), or combination therapy (β = −0.397, P = 0.435). Over the follow-up period, 52 patients died, but there was no significant difference in mortality among the four groups (P = 0.357). Kaplan–Meier analysis showed no significant difference among the study groups (log-rank test, P = 0.362). After further multivariate adjustment, use of β2-agonists (hazard ratio [HR] 0.711, 95% confidence interval [CI] 0.287–1.759; P = 0.460), β-blockers (HR 0.962, 95% CI 0.405–2.285; P = 0.930), or combination therapy (HR 0.638, 95% CI 0.241–1.689; P < 0.366) were likewise not correlated with mortality.ConclusionThere was no association between the use of β2-agonists, β-blockers, or β-blocker-β2-agonist combination therapy with cardiac function and all-cause mortality in elderly male COPD patients, which indicated that they may be used safely in this population.

B-type natriuretic peptides in chronic obstructive pulmonary disease: a systematic review

“…However, NT-proBNP >500 pg/ml predicted one year mortality in 144 patients with predominantly mild to moderate COPD and preserved LVEF (>40%) undergoing major vascular surgery (adjusted HR 7.7 [95% 1.6–37.4]) [49]. NT-proBNP was also associated with all-cause mortality in a larger cohort of 220 elderly men with COPD (adjusted HR 1.61 [1.27–2.06]), although 26% of that cohort had documented HF [50]. …”

“…NT-proBNP was also associated with all-cause mortality in a larger cohort of 220 elderly men with COPD (adjusted HR 1.61 [1.27–2.06]), although 26% of that cohort had documented HF [50]. …”

Beta-blocker therapy in patients with COPD: a systematic literature review and meta-analysis with multiple treatment comparison

“…We included 23 observational studies and 14 RCTs that reported on patients with COPD, in the systematic literature review. Out of a total of 23 observational studies, 21 reported on mortality [ 24 – 44 ], five reported on AECOPD [ 24 , 33 , 35 , 45 , 46 ] three reported on all-cause hospitalization [ 47 – 49 ], one reported on SGRQ [ 45 ] and one reported on SF-36 [ 42 ]. From a total of 14 RCTs, 12 reported on FEV1 [ 50 – 61 ], two each reported on 12MWT [ 59 , 62 ] and 6MWT [ 12 , 56 ] and two reported on SGRQ [ 12 , 56 ] (Fig.…”

“…There were 21 observational studies reporting on mortality [ 24 , 25 , 27 – 41 , 43 , 44 , 64 ] which evaluated the effect of beta-blockers vs. no beta-blocker use, in an overall population of 422,552 patients from at least 11 countries (Additional file 1 : Table S2). According to inclusion criteria, 15 studies enrolled patients with COPD and a CVD indication [ 25 , 27 – 29 , 34 , 37 , 39 , 40 , 43 , 64 , 65 ], while the remaining six [ 24 , 26 , 32 , 33 , 35 , 44 ] did not specify whether those with CVD were specifically excluded; however, all studies had varying percentages of CVD comorbidities. Overall, patient characteristics varied: mean age ranged between 62.8 [ 24 ] and 84.6 [ 44 ] years old and the proportion of males between and 37% [ 26 ] and 100 [ 44 ]%.…”

Arterial hypertension and chronic obstructive pulmonary disease: clinical characteristics and treatment efficasy (according to the national register of arterial hypertension)

“…У пациентов с ХОБЛ в 2-3 раза выше риск развития ССЗ [7]. АГ и ХОБЛ -одно из частых коморбидных состояний, сочетание этих заболеваний определяет высокий уровень инвалидности и неблагоприятный прогноз [9][10][11][12]. Частота АГ у больных с ХОБЛ варьирует от 6,8 до 76,3%, составляя в среднем 34,3%, что зависит от исследуемого контингента больных и методов диагностики заболеваний органов дыхания (спирометрия, рентгенография органов грудной клетки и др.)…”