{"id":3868,"date":"2000-08-19T00:00:00","date_gmt":"2000-08-19T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/rate-of-heart-failure-and-1-year-survival-for-older-people-receiving-low-dose-beta-blocker-therapy-after-myocardial-infarction\/"},"modified":"2023-06-14T19:22:18","modified_gmt":"2023-06-14T23:22:18","slug":"rate-of-heart-failure-and-1-year-survival-for-older-people-receiving-low-dose-beta-blocker-therapy-after-myocardial-infarction","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/rate-of-heart-failure-and-1-year-survival-for-older-people-receiving-low-dose-beta-blocker-therapy-after-myocardial-infarction\/","title":{"rendered":"Rate of heart failure and 1-year survival for older people receiving low-dose beta-blocker therapy after myocardial infarction"},"content":{"rendered":"

Background<\/strong> — Many older people do not receive β-blocker therapy after myocardial infarction or receive doses lower than those tested in trials, perhaps because physicians fear that β-blockers may precipitate heart failure. We examined the relation between use of β-blockers, the dose used, and hospital admission for heart failure and 1-year survival in a cohort of all older patients surviving myocardial infarction in Ontario, Canada.<\/p>\n

Methods<\/strong> — We collected data on a cohort of 13 623 patients aged 66 years or older who were discharged from hospital after a myocardial infarction and who did not receive β-blocker therapy or received low, standard, or high doses. We used Cox's proportional-hazards models to study the association of dose with admission for heart failure and survival with adjustment for factors including age, sex, and comorbidity.<\/p>\n

Findings<\/strong> — Among 8232 patients with no previous history of heart failure, dispensing of β-blocker therapy was associated with a 43% reduction in subsequent admission for heart failure (adjusted risk ratio 0·57 [95% C*** 0·48–0·69]) compared with patients not dispensed this therapy. Among the 4681 patients prescribed β-blockers, the risk of admission was greater in the high-dose than in the low-dose group (1·53 [1·01·2·31]). Among all 13 623 patients in the cohort, 2326 (17·1%) died by 1 year. Compared with those not dispensed β-blocker therapy, the adjusted risk ratio for mortality was lower for all three doses (low 0·40 [0·34–0·47], standard 0·36 [0·31–0·42], high 0·43 [0·33–0·56]).<\/p>\n

Interpretation<\/strong> — Compared with high-dose β-blocker therapy, low-dose treatment is associated with a lower rate of hospital admission for heart failure and has a similar 1-year survival benefit. Our findings support the need for a randomised controlled trial comparing doses of β-blocker therapy in elderly patients.<\/p>\n","protected":false},"excerpt":{"rendered":"

Background — Many older people do not receive β-blocker therapy after myocardial infarction or receive doses lower than those tested in trials, perhaps because physicians fear that β-blockers may precipitate heart failure. We examined the relation between use of β-blockers, the dose used, and hospital admission for heart failure and 1-year survival in a cohort […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[40,62,56],"migration-helper-qa-sample-set":[],"class_list":["post-3868","journal_article","type-journal_article","status-publish","hentry","topic-cardiovascular-disease","topic-health-services-research","topic-pharmacoepidemiology-and-drug-safety"],"acf":{"citation":"Rochon PA, Tu JV, Anderson GM, Gurwitz JH, Clark JP, Lau P, Szalai JP, Sykora K, Naylor CD. Lancet<\/em>. 2000; 356(9230):639-44.","source_url":"","ices_scientist":[1340,1382,1304],"site":[6733,6735],"research_program":[6742,6746,6740],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"BBD19E1A-5658-4102-9C78-125EF58FC66C","sitecore_item_name":"Rate-of-heart-failure-and-1-year-survival-for-older-people-receiving-low-dose-beta-blocker","sitecore_field_values":"{\n \"Title\": \"Rate of heart failure and 1-year survival for older people receiving low-dose beta-blocker therapy after myocardial infarction\",\n \"Short title\": \"Rate of heart failure and 1-year\",\n \"Citation\": \"

Rochon PA, Tu JV, Anderson GM, Gurwitz JH, Clark JP, Lau P, Szalai JP, Sykora K, Naylor CD. Lancet<\/em>. 2000; 356(9230):639-44.<\/p>\",\n \"Abstract\": \"

Background<\/strong> — Many older people do not receive β-blocker therapy after myocardial infarction or receive doses lower than those tested in trials, perhaps because physicians fear that β-blockers may precipitate heart failure. We examined the relation between use of β-blockers, the dose used, and hospital admission for heart failure and 1-year survival in a cohort of all older patients surviving myocardial infarction in Ontario, Canada.<\/p>rn

Methods<\/strong> — We collected data on a cohort of 13\u2008623 patients aged 66 years or older who were discharged from hospital after a myocardial infarction and who did not receive β-blocker therapy or received low, standard, or high doses. We used Cox's proportional-hazards models to study the association of dose with admission for heart failure and survival with adjustment for factors including age, sex, and comorbidity.<\/p>rn

Findings<\/strong> — Among 8232 patients with no previous history of heart failure, dispensing of β-blocker therapy was associated with a 43% reduction in subsequent admission for heart failure (adjusted risk ratio 0·57 [95% C*** 0·48–0·69]) compared with patients not dispensed this therapy. Among the 4681 patients prescribed β-blockers, the risk of admission was greater in the high-dose than in the low-dose group (1·53 [1·01·2·31]). Among all 13\u2008623 patients in the cohort, 2326 (17·1%) died by 1 year. Compared with those not dispensed β-blocker therapy, the adjusted risk ratio for mortality was lower for all three doses (low 0·40 [0·34–0·47], standard 0·36 [0·31–0·42], high 0·43 [0·33–0·56]).<\/p>rn

Interpretation<\/strong> — Compared with high-dose β-blocker therapy, low-dose treatment is associated with a lower rate of hospital admission for heart failure and has a similar 1-year survival benefit. 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