This study compared the survival and the risk of heart failure (HF), chronic obstructive
pulmonary disease (COPD), diabetes mellitus (DM), hypoglycemia, and renal failure
(RF) hospitalizations in geriatric patients exposed to carvedilol or metoprolol. Data
sources were Danish administrative registers. Patients aged ≥65 and having HF, COPD,
and DM were followed for 1 year from the first β-blocker prescription redemption.
Patients' characteristics were used to 1:1 propensity score match carvedilol and metoprolol
users. A Cox regression model was used to compute the hazard ratio (HR) of study outcomes.
For statistically significant associations, a conditional inference tree was used
to assess predictors most associated with the outcome. In total, 1,424 patients were
included. No statistically significant differences were observed for survival (HR
0.86; 95% confidence interval [CI] 0.67 to 1.11, p = 0.240) between carvedilol/metoprolol
users. The same applied to COPD (HR 0.88; 95% CI 0.75 to 1.05, p = 0.177), DM (HR
0.95; 95% CI 0.82 to 1.10, p = 0.485), hypoglycemia (HR 0.88; 95% CI 0.47 to 1.67,
p = 0.707), and RF (HR 1.25; 95% CI 0.93 to 1.69, p = 0.142) hospitalizations. Carvedilol
users had a 38% higher hazard then metoprolol users of HF hospitalization during the
follow-up period (HR 1.38; 95% CI 1.19 to 1.60, p <0.001). Artificial intelligence
identified carvedilol exposure as the most important predictor for HF hospitalization.
In conclusion, we found an increased risk of HF hospitalization for carvedilol users
with this triad of diseases but no statistically significant differences in survival
or risk of COPD, DM, hypoglycemia, and RF hospitalizations.
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Article info
Publication history
Published online: January 09, 2020
Received in revised form:
December 18,
2019
Received:
October 16,
2019
Footnotes
Funding: Assist. Prof. Maurizio Sessa and Prof. Morten Andersen are supported by a grant from the Novo Nordisk Foundation to the University of Copenhagen (NNF15SA0018404, Copenhagen, Denmark).
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