The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction
- Author:
Ki Hong CHOI
1
;
Ga Yeon LEE
;
Jin Oh CHOI
;
Eun Seok JEON
;
Hae Young LEE
;
Sang Eun LEE
;
Jae Joong KIM
;
Shung Chull CHAE
;
Sang Hong BAEK
;
Seok Min KANG
;
Dong Ju CHOI
;
Byung Su YOO
;
Kye Hun KIM
;
Myeong Chan CHO
;
Hyun Young PARK
;
Byung Hee OH
Author Information
- Publication Type:Original Article
- From:The Korean Journal of Internal Medicine 2019;34(5):1030-1039
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS:It is unknown whether different β-blockers (BBs) have variable effects on long-term survival of patients with heart failure with reduced ejection fraction (HFrEF). This study compares the effects of two BBs, carvedilol and bisoprolol, on survival in patients with HFrEF.
METHODS:The Korean Acute Heart Failure (KorAHF) registry is a prospective multicenter cohort that includes 5,625 patients who were hospitalized for acute heart failure (AHF). We selected 3,016 patients with HFrEF and divided this study population into two groups: BB at discharge (n = 1,707) or no BB at discharge (n = 1,309). Among patients with BB at discharge, subgroups were formed based on carvedilol prescription (n = 831), or bisoprolol prescription (n = 553). Propensity score matching analysis was performed.
RESULTS:Among patients who were prescribed a BB at discharge, 60.5% received carvedilol and 32.7% received bisoprolol. There was a significant reduction in all-cause mortality in those patients with HFrEF prescribed a BB at discharge compared to those who were not (BB vs. no BB, 26.1% vs. 40.8%; hazard ratio [HR], 0.59; 95% confidence interval [CI], 0.52 to 0.67; p < 0.001). However, there was no significant difference in the rate of all-cause mortality between those receiving different types of BB (carvedilol vs. bisoprolol, 27.5% vs. 23.5%; HR, 1.21; 95% CI, 0.99 to 1.47; p = 0.07). Similar results were observed after propensity score matching analysis (508 pairs, 26.2% vs. 23.8%; HR, 1.10; 95% CI, 0.86 to 1.40; p = 0.47).
CONCLUSIONS:In the treatment of AHF with reduced EF after hospitalization, mortality benefits of carvedilol and bisoprolol were comparable.
