– Assistant Professor, National Taiwan University Hospital, National Taiwan University, Zhong Zheng Qu, Taiwan
Background: It has been proven that the usage beta-blocker (BB) can improve the mortality of heart failure (HF) patients. Meanwhile, BB plays a vital role in rate control of atrial fibrillation (AF) patients. Nevertheless, there hasn’t sufficient investigation toward the effects of individual BB on AF patients combined with HF.
Objectives: To assess the effects for AF patients who used different BB. In addition, examing whether HF comorbidity will affect the results is the other aim.
Methods: This study is a retrospective cohort study based on National Health Insurance Research Database (NHIRD) from 2005 to 2011. AF patients are included and divided to with HF group and without HF group. The further classification is based on records of BB usage. Patients used bisoprolol, carvedilol and metoprolol are the main population this study focus on. To reduce selection bias, propensity score is applied to match comparison group. The results are assessed after constructing groups similar to randomized controlled trial.
Results: Compared carvedilol with bisoprolol, the application of carvedilol shows higher risk of re-hospitalization of cardiovascular events in AF patients (HR 1.12; 95% CI 1.03 to 1.22; P=0.0062). This result is similar in the subgroup which AF patients without HF (HR 1.19; 95% CI 1.02 to 1.39; P=0.0242). Nonetheless, in AF patients combined with HF, the difference isn’t significant (HR 1.02; 95% CI 0.92 to 1.13; P=0.6998).
Conclusions: The effects of BB may be varied from one to another. Patients applied bisoprolol seems to have lower risk on the happening of cardiovascular re-hospitalization compared with patients used carvedilol in AF patients. This results may differ because of comorbidity of HF.
