Outcomes of β-blocker use in pulmonary arterial hypertension: a propensity-matched analysis.

Academic Article

Abstract

  • The utility and safety of β-blockers in pulmonary hypertension is controversial. Anecdotal reports suggest that β-blockers may be harmful in these patients. The aim of our study was to evaluate outcomes of β-blocker use in pulmonary hypertension.We reviewed patients from our pulmonary hypertension registry between 2000 and 2011. Patients who continued to use β-blockers were compared to those who never used β-blockers for all-cause mortality, time to clinical worsening events, defined as death, lung transplantation and hospitalisation due to pulmonary hypertension. We also evaluated the effect of β-blockers on 6-min walking distance and New York Heart Association (NYHA) functional class.133 patients used β-blockers and 375 patients never used β-blockers. Mean±sd age was 57±16 years and the median follow-up period was 78 months. Propensity-matched analysis showed that the adjusted odds ratio (95% CI) for mortality with β-blocker use was 1.13 (0.69-1.82) and for clinical worsening events was 0.96 (0.55-1.68). No significant difference was noted in probability of survival and time to clinical worsening events. Patients on β-blockers walked a shorter distance on follow-up 6 min walk test; follow-up NYHA class was similar between groups.Pulmonary hypertension patients receiving β-blockers had a similar survival and time to clinical worsening events compared to patients not receiving them. Functional outcomes were similar, although β-blocker use was associated with a tendency towards shorter walking distance.
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    Keywords

  • Adrenergic beta-Antagonists, Adult, Aged, Case-Control Studies, Cause of Death, Confidence Intervals, Female, Humans, Hypertension, Pulmonary, Kaplan-Meier Estimate, Male, Middle Aged, Prognosis, Pulmonary Wedge Pressure, Reference Values, Registries, Retrospective Studies, Risk Assessment, Severity of Illness Index, Statistics, Nonparametric, Survival Analysis, Treatment Outcome
  • Digital Object Identifier (doi)

    Authorlist

  • Bandyopadhyay D; Bajaj NS; Zein J; Minai OA; Dweik RA
  • Start Page

  • 750
  • End Page

  • 760
  • Volume

  • 46
  • Issue

  • 3