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

Research output: Contribution to journalArticle

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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

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Bisoprolol
Heart Failure
Mortality
Propensity Score
Confidence Intervals
Prescriptions
Survival
carvedilol
Registries
Hospitalization

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Choi, Ki Hong ; Lee, Ga Yeon ; Choi, Jin Oh ; Jeon, Eun Seok ; Lee, Hae Young ; Lee, Sang Eun ; Kim, Jae Joong ; Chae, Shung Chull ; Baek, Sang Hong ; Kang, Seok Min ; Choi, Dong Ju ; Yoo, Byung Su ; Kim, Kye Hun ; Cho, Myeong Chan ; Park, Hyun Young ; Oh, Byung Hee. / The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction. In: Korean Journal of Internal Medicine. 2019 ; Vol. 34, No. 5. pp. 1030-1039.
@article{533abd85e88c42a58c6d4d846ae987d0,
title = "The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction",
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.",
author = "Choi, {Ki Hong} and Lee, {Ga Yeon} and Choi, {Jin Oh} and Jeon, {Eun Seok} and Lee, {Hae Young} and Lee, {Sang Eun} and Kim, {Jae Joong} and Chae, {Shung Chull} and Baek, {Sang Hong} and Kang, {Seok Min} and Choi, {Dong Ju} and Yoo, {Byung Su} and Kim, {Kye Hun} and Cho, {Myeong Chan} and Park, {Hyun Young} and Oh, {Byung Hee}",
year = "2019",
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language = "English",
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pages = "1030--1039",
journal = "Korean Journal of Internal Medicine",
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Choi, KH, Lee, GY, Choi, JO, Jeon, ES, Lee, HY, Lee, SE, Kim, JJ, Chae, SC, Baek, SH, Kang, SM, Choi, DJ, Yoo, BS, Kim, KH, Cho, MC, Park, HY & Oh, BH 2019, 'The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction', Korean Journal of Internal Medicine, vol. 34, no. 5, pp. 1030-1039. https://doi.org/10.3904/kjim.2018.009

The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction. / Choi, Ki Hong; Lee, Ga Yeon; Choi, Jin Oh; Jeon, Eun Seok; Lee, Hae Young; Lee, Sang Eun; Kim, Jae Joong; Chae, Shung Chull; Baek, Sang Hong; Kang, Seok Min; Choi, Dong Ju; Yoo, Byung Su; Kim, Kye Hun; Cho, Myeong Chan; Park, Hyun Young; Oh, Byung Hee.

In: Korean Journal of Internal Medicine, Vol. 34, No. 5, 09.2019, p. 1030-1039.

Research output: Contribution to journalArticle

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T1 - The mortality benefit of carvedilol versus bisoprolol in patients with heart failure with reduced ejection fraction

AU - Choi, Ki Hong

AU - Lee, Ga Yeon

AU - Choi, Jin Oh

AU - Jeon, Eun Seok

AU - Lee, Hae Young

AU - Lee, Sang Eun

AU - Kim, Jae Joong

AU - Chae, Shung Chull

AU - Baek, Sang Hong

AU - Kang, Seok Min

AU - Choi, Dong Ju

AU - Yoo, Byung Su

AU - Kim, Kye Hun

AU - Cho, Myeong Chan

AU - Park, Hyun Young

AU - Oh, Byung Hee

PY - 2019/9

Y1 - 2019/9

N2 - 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.

AB - 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.

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