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Evaluation of the protective effects of β‐blockers in the management of acute exacerbations of chronic obstructive pulmonary disease
Author(s) -
Thomas Cameron D.,
Dupree Lori H.,
DeLosSantos Marci,
Ferreira Jason A.
Publication year - 2019
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12767
Subject(s) - medicine , exacerbation , retrospective cohort study , copd , cohort , beta blocker , bradycardia , myocardial infarction , emergency department , acute exacerbation of chronic obstructive pulmonary disease , anesthesia , heart failure , heart rate , blood pressure , psychiatry
Summary What is known and objective The purpose of this study was to evaluate the association between early β‐blocker continuation and major inpatient events in patients hospitalized for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods This single centre, retrospective, investigational review board approved cohort study evaluated patients admitted for a primary diagnosis of AECOPD. Patients were evaluated based on early continuation of a β‐blocker whether a β‐blocker was initiated within 24 hours of admission and continued for at least 72 hours. Patients with AECOPD who did not receive β‐blockers were assigned to the control group. Major inpatient events were a composite outcome composed of arrhythmias, myocardial infarction (MI) and death. Safety data were collected on the incidences of bradycardia, bronchospasms and hypotension. Results and discussion Of the 96 patients admitted for AECOPD, fifty‐five patients were included in the early β‐blocker group and forty‐one patients in the control group. Early β‐blocker utilization was associated with a significantly lower rate of major inpatient events compared with the control group (40% vs 80.5%; P < 0.001). Arrhythmias were significantly less common in the early β‐blocker group (30.9% vs 65.9%; P = 0.001); however, there were no significant differences in the rates of MI (9.1% vs 14.6%; P = 0.54), death (0 vs 0) or safety outcomes between groups. What is new and conclusion β‐blocker therapy could result in a paradigm shift in managing chronic obstructive pulmonary disease patients from a true cardiopulmonary approach. This retrospective cohort study demonstrated early β‐blocker continuation in patients admitted for an AECOPD was associated with less major inpatient events, primarily arrhythmias.