detail content area
Korean Journal of Internal Medicine, 2019. 34, 1030-1039, DOI: https://doi.org/10.3904/kjim.2018.009
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
Background/Aims: It is unknown whether different β-blockers (BBs) have variableeffects on long-term survival of patients with heart failure with reduced ejectionfraction (HFrEF). This study compares the effects of two BBs, carvedilol andbisoprolol, on survival in patients with HFrEF.
Methods: The Korean Acute Heart Failure (KorAHF) registry is a prospectivemulticenter cohort that includes 5,625 patients who were hospitalized for acuteheart failure (AHF). We selected 3,016 patients with HFrEF and divided this studypopulation 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 oncarvedilol preion (n = 831), or bisoprolol preion (n = 553). Propensityscore matching analysis was performed.
Results: Among patients who were prescribed a BB at discharge, 60.5% receivedcarvedilol and 32.7% received bisoprolol. There was a significant reduction in allcausemortality in those patients with HFrEF prescribed a BB at discharge comparedto 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 significantdifference in the rate of all-cause mortality between those receiving differenttypes 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.
- DOI: https://doi.org/10.3904/kjim.2018.009
- ISBN or ISSN: 1226-3303
- 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
- This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.