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dc.contributor.authorGo, Alan S.
dc.contributor.authorYang, Jingrong
dc.contributor.authorGurwitz, Jerry H.
dc.contributor.authorHsu, John
dc.contributor.authorLane, Kimberly
dc.contributor.authorPlatt, Richard
dc.date2022-08-11T08:09:23.000
dc.date.accessioned2022-08-23T16:28:39Z
dc.date.available2022-08-23T16:28:39Z
dc.date.issued2007-08-15
dc.date.submitted2009-09-25
dc.identifier.citationAm J Cardiol. 2007 Aug 15;100(4):690-6. Epub 2007 Jun 26.
dc.identifier.issn0002-9149
dc.identifier.pmid17697830
dc.identifier.pmid17697830
dc.identifier.urihttp://hdl.handle.net/20.500.14038/37066
dc.description.abstractPlacebo-controlled randomized trials have demonstrated the efficacy of selected beta blockers on outcomes in chronic heart failure (HF), but the relative effectiveness of different beta blockers in usual clinical care is poorly understood. We compared 12-month risk of rehospitalization for HF associated with receipt of different beta blockers in 7,883 adults hospitalized for HF within 2 large health plans between January 1, 2001 and December 31, 2002. Beta-blocker use was ascertained from electronic pharmacy databases and readmissions within 12 months were identified from hospital discharge databases. Extended Cox regression was used to examine the association between receipt of different beta blockers and risk of readmission for HF after adjustment for potential confounders. During follow-up, there were 3,234 person-years of exposure to beta blockers (39.3% atenolol, 42.0% metoprolol tartrate, 12.3% carvedilol, and 6.4% other). Crude 12-month rates of readmissions for HF were high overall (42.6 per 100 person-years). After adjustment for potential confounders, cumulative exposure to each beta blocker, and propensity to receive carvedilol compared with atenolol, adjusted risks of readmission were not significantly different for metoprolol tartrate (adjusted hazard ratio 0.95, 95% confidence interval 0.85 to 1.05) or for carvedilol (adjusted hazard ratio 0.92, 95% confidence interval 0.74 to 1.14). In conclusion, in a contemporary cohort of high-risk patients hospitalized with HF, we found that adjusted risks of rehospitalization for HF within 12 months were not significantly different in patients receiving atenolol, shorter-acting metoprolol tartrate, or carvedilol.
dc.language.isoen_US
dc.publisherExcerpta Medica
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17697830&dopt=Abstract">Link to article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1016/j.amjcard.2007.03.084
dc.subjectAdrenergic beta-Antagonists
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectAluminum
dc.subjectAtenolol
dc.subjectCalifornia
dc.subjectCarbazoles
dc.subjectConfidence Intervals
dc.subjectDrug Administration Schedule
dc.subjectDrug Therapy, Combination
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectHeart Failure
dc.subjectHumans
dc.subjectMale
dc.subjectMetoprolol
dc.subjectMiddle Aged
dc.subjectPatient Readmission
dc.subjectPropanolamines
dc.subjectProportional Hazards Models
dc.subjectRetrospective Studies
dc.subjectRisk Factors
dc.subjectTartrates
dc.subjectTime Factors
dc.subjectTreatment Outcome
dc.subjectHealth Services Research
dc.subjectMedicine and Health Sciences
dc.titleComparative effectiveness of beta-adrenergic antagonists (atenolol, metoprolol tartrate, carvedilol) on the risk of rehospitalization in adults with heart failure.
dc.typeJournal Article
dc.source.journaltitleThe American journal of cardiology
dc.source.volume100
dc.source.issue4
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/meyers_pp/45
dc.identifier.contextkey1016853
html.description.abstract<p>Placebo-controlled randomized trials have demonstrated the efficacy of selected beta blockers on outcomes in chronic heart failure (HF), but the relative effectiveness of different beta blockers in usual clinical care is poorly understood. We compared 12-month risk of rehospitalization for HF associated with receipt of different beta blockers in 7,883 adults hospitalized for HF within 2 large health plans between January 1, 2001 and December 31, 2002. Beta-blocker use was ascertained from electronic pharmacy databases and readmissions within 12 months were identified from hospital discharge databases. Extended Cox regression was used to examine the association between receipt of different beta blockers and risk of readmission for HF after adjustment for potential confounders. During follow-up, there were 3,234 person-years of exposure to beta blockers (39.3% atenolol, 42.0% metoprolol tartrate, 12.3% carvedilol, and 6.4% other). Crude 12-month rates of readmissions for HF were high overall (42.6 per 100 person-years). After adjustment for potential confounders, cumulative exposure to each beta blocker, and propensity to receive carvedilol compared with atenolol, adjusted risks of readmission were not significantly different for metoprolol tartrate (adjusted hazard ratio 0.95, 95% confidence interval 0.85 to 1.05) or for carvedilol (adjusted hazard ratio 0.92, 95% confidence interval 0.74 to 1.14). In conclusion, in a contemporary cohort of high-risk patients hospitalized with HF, we found that adjusted risks of rehospitalization for HF within 12 months were not significantly different in patients receiving atenolol, shorter-acting metoprolol tartrate, or carvedilol.</p>
dc.identifier.submissionpathmeyers_pp/45
dc.contributor.departmentDepartment of Medicine, Division of Geriatric Medicine
dc.contributor.departmentMeyers Primary Care Institute


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