Background: Randomized controlled trials have demonstrated the efficacy of selected β-blockers for preventing cardiovascular (CV) events in patients following myocardial infarction (MI) or with heart failure (HF). However, the effectiveness of β-blockers for preventing CV events in patients with hypertension has been questioned recently, but it is unclear whether this is a class effect.
Methods: Using electronic medical record and health plan data from the Cardiovascular Research Network Hypertension Registry, we compared incident MI, HF, and stroke in patients who were new β-blocker users between 2000 and 2009. Patients had no history of CV disease and had not previously filled a prescription for a β-blocker. Cox proportional hazards regression was used to examine the associations of atenolol and metoprolol tartrate with incident CV events using both standard covariate adjustment (n = 120,978) and propensity score-matching methods (n = 22,352).
Results: During follow-up (median, 5.2 years), there were 3517 incident MI, 3272 incident HF, and 3664 incident stroke events. Hazard ratios for MI, HF, and stroke in metoprolol tartrate users were 0.99 (95% CI, 0.97-1.02), 0.99 (95% CI, 0.96-1.01), and 0.99 (95% CI, 0.97-1.02), respectively. An alternative approach using propensity score matching yielded similar results in 11,176 new metoprolol tartrate users, who were similar to 11,176 new atenolol users with regard to demographic and clinical characteristics.
Conclusions: There were no statistically significant differences in incident CV events between atenolol and metoprolol tartrate users with hypertension. Large registries similar to the one used in this analysis may be useful for addressing comparative effectiveness questions that are unlikely to be resolved by randomized trials.
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http://dx.doi.org/10.1001/archinternmed.2012.4276 | DOI Listing |
Eur J Pharm Sci
January 2025
Preclinical Sciences & Translational Safety, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium. Electronic address:
The purpose of this study was to evaluate EpiColon, a novel human organotypic 3D colon microtissue prototype, developed to assess colonic drug disposition, with a particular focus on permeability ranking, and compare its performance to Caco-2 monolayers. EpiColon was characterized for barrier function using transepithelial electrical resistance (TEER), morphology via histology and immunohistochemistry, and functionality through drug transport studies measuring apparent permeability (P). Cutoff thresholds for the permeability of FITC-dextran 4 kDa (FD4), FITC-dextran 10 kDa (FD10S), and [C]mannitol were established to monitor microtissue integrity.
View Article and Find Full Text PDFBMC Cardiovasc Disord
January 2025
Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Background: Evidence-based beta-blockers are essential in managing heart failure with reduced ejection fraction (HFrEF) and are known to improve cardiovascular outcomes. Despite robust nascent guideline recommendations, studies indicate that beta-blockers are often underutilized or administered below target doses. This shivery issue is particularly relevant in Ethiopia, where comprehensive evaluations of beta-blocker utilization and dosing practices are limited.
View Article and Find Full Text PDFJ Cardiovasc Pharmacol
January 2025
Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Positive inotropic responses upon administration of milrinone, an inhibitor of the phosphodiesterase enzyme (PDE), involve a well-pronounced positive chronotropic effect. Here we tested whether milrinone evokes this chronotropic response solely by PDE inhibition or by a concerted action that involve additional pharmacological targets. Milrinone stimulated increases in heart rate were studied in right atrial preparations of guinea pig in the presence or absence of inhibitors of putative ancillary molecular pathways or ion channels: i.
View Article and Find Full Text PDFFront Cardiovasc Med
January 2025
Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Background: Painful left bundle branch block (LBBB) syndrome is an uncommon disease that is defined as intermittent episodes of angina associated with simultaneous LBBB changes on an electrocardiogram (ECG) with the absence of flow-limiting coronary artery disease or ischemia on functional testing. Vasovagal syncope (VVS) is the most common cause of syncope and can be provoked by sublingual nitroglycerin (NTG). Herein, we report a case of painful LBBB syndrome complicated with VVS, which was misdiagnosed as acute coronary syndrome and cardiogenic shock.
View Article and Find Full Text PDFFront Cardiovasc Med
January 2025
Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Introduction: Focal atrial tachycardia (FAT) is predominant in the pediatric population. Recent research has identified cases of sustained FAT originating from the interatrial septum (IAS); a subset of cases presents a unique challenge, with foci originating from the peri-patent foramen ovale (peri-PFO), requiring specialized management during catheter ablation. Here, we present a rare case of peri-PFO-associated FAT that resulted in tachycardia-related cardiomyopathy and propose a comprehensive multipath joint strategy for the successful treatment of PFO-associated FAT.
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