 |
|
 -Blocker Use in Long-term Dialysis Patients
Association With Hospitalized Heart Failure and Mortality
LTC(P) Kevin C. Abbott, MC, USA;
Fernando C. Trespalacios, MD;
Lawrence Y. Agodoa, MD;
LTC Allen J. Taylor, MC, USA;
George L. Bakris, MD
Arch Intern Med. 2004;164:2465-2471.
Background  -Blockers have been shown to be beneficial in the treatment and prevention of heart failure (HF) in the general population, but they have not been assessed for their association with nonfatal HF in a nationally representative population of long-term dialysis patients.
Methods We conducted a retrospective cohort study of 2550 patients enrolled in the US Renal Data System (USRDS) Wave 2 who were Medicare eligible at the start of the study. Analysis was stratified by the presence or absence of a known diagnosis of HF, and patients followed up until December 31, 2000. Cox regression analysis, including propensity scores, was used to model adjusted hazard ratios for -blocker use (assessed separately by cardioselective activity and lipid solubility) with time to the first Medicare institutional claim for HF, cardiovascular-related death, or death from any cause.
Results In patients without a previous history of HF, -blocker use was significantly associated with a lower adjusted risk of HF (adjusted hazard ratio, 0.69; 95% confidence interval, 0.52-0.91; P=.008), with a similar reduction in risk of cardiac-related and all-cause death. -Blocker use had no statistically significant associations with outcomes in patients with previous HF.
Conclusions In dialysis patients without a previous documented history of HF, -blocker use was associated with a lower risk of new HF, cardiovascular death, and death from any cause. No such associations were seen for dialysis patients with a previous history of HF. These results are hypothesis generating only and should be confirmed in randomized trials.
Author Affiliations: Nephrology (Drs Abbott, Trespalacios, Agodoa, and Bakris) and Cardiology (Dr Taylor) Services, Walter Reed Army Medical Center, Washington, DC; Divisions of Nephrology (Dr Abbott) and Cardiology (Dr Taylor), Uniformed Services University of the Health Sciences, Bethesda, Md; Nephrology Service, Madigan Army Medical Center, Ft Lewis, Wash (Dr Trespalacios); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda (Dr Agodoa); and Preventive Medicine Service, Rush Presbyterian Medical Center, Chicago, Ill (Dr Bakris).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Heart Failure-Related Hospitalization in the U.S., 1979 to 2004
Fang et al.
J Am Coll Cardiol 2008;52:428-434.
ABSTRACT
| FULL TEXT
Long-Term Survival of Incident Hemodialysis Patients Who Are Hospitalized for Congestive Heart Failure, Pulmonary Edema, or Fluid Overload
Banerjee et al.
CJASN 2007;2:1186-1190.
ABSTRACT
| FULL TEXT
The treatment of coronary artery disease in patients with chronic kidney disease
Edwards et al.
QJM 2006;99:723-736.
ABSTRACT
| FULL TEXT
Survival and body fat in hemodialysis patients: true association or effects of concomitant therapy?
Sandek et al.
Am. J. Clin. Nutr. 2006;84:663-664.
FULL TEXT
Heart Failure and Nephropathy: Catastrophic and Interrelated Complications of Diabetes
Gilbert et al.
CJASN 2006;1:193-208.
ABSTRACT
| FULL TEXT
The association between BP and mortality in patients on chronic peritoneal dialysis
Dasselaar et al.
Nephrol Dial Transplant 2006;21:552-552.
FULL TEXT
Do Beta-Blockers Prevent New-Onset HF in Dialysis Patients?
Journal Watch Cardiology 2005;2005:4-4.
FULL TEXT
{beta}-Blockers Could Prevent New Heart Failure in Dialysis Patients
JWatch General 2005;2005:3-3.
FULL TEXT
|
