Beta-blocker use and risk of acute exacerbations of COPD following first-time myocardial infarction. A Danish nationwide cohort study.
D. Rasmussen (Naestved, Denmark), U. Bodtger (Naestved, Denmark), M. Lamberts (Hellerup, Denmark), P. Lange (Copenhagen, Denmark), M. Jensen (Hellerup, Denmark)
Source: International Congress 2019 – More and more COPD
Session: More and more COPD
Session type: Thematic Poster
Number: 4425
Disease area: Airway diseases
Abstract Introduction
COPD patients are undertreated with beta-blockers following myocardial infarction (MI), possibly due to fear for acute exacerbations (AECOPD). We investigated the association between beta-blocker use and risk of AECOPD in patients following first-time MI.
Methods
Danish nationwide study of patients with COPD following hospitalisation for MI from 2003 to 2015. Multivariable, time-dependent Cox regression accounting for varying beta-blocker use during up to 13 years of follow-up.
Results
A total of 10,884 patients with COPD were discharged after MI (median age 75 years, 52% male). The 1-year rate of AECOPD was 35%.
Beta-blocker use was associated with lower risk of AECOPD (multivariable adjusted HR 0.78, 95%CI 0.74-0.83)(Figure 1). Results were similar in a subgroup of 1,118 patients with full clinical data on COPD severity and symptom burden (median FEV1% predicted 46; majority had moderate dyspnoea), and in 1,358 patients with a history of frequent exacerbations and triple inhalation therapy (1-year rate of AECOPD 70%). Fine and Gray competing risk regression, accounting for death as competing event, showed similar results.
Conclusions
Beta-blocker use was associated with lower risk of AECOPD following MI independently of COPD severity, symptom burden, and exacerbation history. These finding support safety of beta-blockers in patients with COPD.
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D. Rasmussen (Naestved, Denmark), U. Bodtger (Naestved, Denmark), M. Lamberts (Hellerup, Denmark), P. Lange (Copenhagen, Denmark), M. Jensen (Hellerup, Denmark). Beta-blocker use and risk of acute exacerbations of COPD following first-time myocardial infarction. A Danish nationwide cohort study.. 4425
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