The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction

Ki Hong Choi, 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

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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.

Original languageEnglish
Pages (from-to)1030-1039
Number of pages10
JournalKorean Journal of Internal Medicine
Volume34
Issue number5
DOIs
Publication statusPublished - 2019 Sep

All Science Journal Classification (ASJC) codes

  • Internal Medicine

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    Choi, K. H., Lee, G. Y., Choi, J. O., Jeon, E. S., Lee, H. Y., Lee, S. E., Kim, J. J., Chae, S. C., Baek, S. H., Kang, S. M., Choi, D. J., Yoo, B. S., Kim, K. H., Cho, M. C., Park, H. Y., & Oh, B. H. (2019). The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction. Korean Journal of Internal Medicine, 34(5), 1030-1039. https://doi.org/10.3904/kjim.2018.009