Cardioselective versus Non-Cardioselective Beta-Blockers and Outcomes in Patients with Atrial Fibrillation and Chronic Obstructive Pulmonary Disease.

Content Provider	Europe PMC
Author	Vlachopoulou, Dimitra Balomenakis, Charalampos Kartas, Anastasios Samaras, Athanasios Papazoglou, Andreas S. Moysidis, Dimitrios V. Barmpagiannos, Konstantinos Kyriakou, Melina Papanastasiou, Anastasios Baroutidou, Amalia Vouloagkas, Ioannis Tzikas, Apostolos Giannakoulas, George
Editor	Knecht, Sebastien
Copyright Year	2023
Abstract	Background: Atrial fibrillation (AF) and chronic obstructive pulmonary disease (COPD) have been independently associated with increased mortality; however, there is no evidence regarding beta-blocker cardioselectivity and long-term outcomes in patients with AF and concurrent COPD. Methods: This post hoc analysis of the MISOAC-AF randomized trial (NCT02941978) included patients hospitalized with comorbid AF. At discharge, all patients were classified according to the presence of COPD; patients with COPD on beta-blockers were classified according to beta-blocker cardioselectivity. Adjusted hazard ratios (aHRs) were calculated by using multivariable Cox regression models. The primary outcome was all-cause mortality, and the secondary outcomes were cardiovascular mortality and hospitalizations. Results: Of 1103 patients with AF, 145 (13%) had comorbid COPD. Comorbid COPD was associated with an increased risk of all-cause (aHR, 1.33; 95% confidence interval (CI), 1.02 to 1.73) and cardiovascular mortality (aHR 1.47; 95% CI, 1.10 to 1.99), but not with increased risk of hospitalizations (aHR 1.10; 95% CI, 0.82 to 1.48). The use of cardioselective versus non-cardioselective beta-blockers was associated with similar all-cause mortality (aHR 1.10; 95% CI, 0.63 to 1.94), cardiovascular mortality (aHR 1.33; 95% CI, 0.71 to 2.51), and hospitalizations (aHR 1.65; 95% CI 0.80 to 3.38). Conclusions: In recently hospitalized patients with AF, the presence of COPD was independently associated with increased risk of all-cause and cardiovascular mortality. No difference between cardioselective and non-cardioselective beta-blockers, regarding clinical outcomes, was identified.
Journal	Journal of Clinical Medicine [J Clin Med]
Volume Number	12
DOI	10.3390/jcm12093063
PubMed Central reference number	PMC10179681
Issue Number	9
PubMed reference number	37176504
e-ISSN	20770383
Language	English
Publisher	Molecular Diversity Preservation International (MDPI)
Publisher Date	2023-04-23
Access Restriction	Open
Subject Keyword	cardioselective beta-blockers non-cardioselective beta-blockers beta-blockers atrial fibrillation chronic obstructive pulmonary disease mortality
Content Type	Text
Resource Type	Article
Subject	Medicine