EFFECT OF CLASS OF BETA-BLOCKERS, CARDIOSELECTIVE VERSUS NON-CARDIOSELECTIVE, ON COPD EXACERBATIONS IN PATIENT WITH COPD AND CARDIOVASCULAR DISEASES
Jebbawi LA, Jia KQ, and Ruzieh M. EFFECT OF CLASS OF BETA-BLOCKERS, CARDIOSELECTIVE VERSUS NON-CARDIOSELECTIVE, ON COPD EXACERBATIONS IN PATIENT WITH COPD AND CARDIOVASCULAR DISEASES. Journal of the American College of Cardiology 2021; 77(18):1687.
Journal of the American College of Cardiology
Background: Several guideline committees and experts advocate cardioselective beta-blockers (βB) over non-cardioselective βB use in patients with heart disease and chronic obstructive pulmonary disease (COPD), as a safer option to reduce COPD exacerbations. We sought to test this hypothesis using a meta-analysis and meta-regression of available studies.
Methods: Pubmed, and MEDLINE were searched for relevant studies. Risk ratio (RR) of COPD exacerbations was calculated using the Mantel Haenszel random effect model and a meta-regression analysis was performed using the percentage of patients using cardioselective βB in each trial as a moderator variable.
Results: Data from 10 studies comprising 75,504 patients were included. There was no statistically significant difference in the rate of COPD exacerbations and/or COPD related hospitalizations with cardioselective vs non-cardioselective βB (RR: 1.02, 95% CI: 0.88 - 1.18), figure 1A. When controlling for the percentage of cardioselective βB use in each trial as a moderate variable, there was no significant change in heterogeneity (Tau2: 0.09, p <0.001) and there was no correlation between the percentage of patients used cardioselective βB in each study and the change in COPD exacerbations and/or COPD related hospitalizations, figure 1B.
Conclusion: We found no evidence to support that cardioselective βB were associated with a lower risk of COPD exacerbations compared to non-cardioselective βB.