Beta-blocker under-use in COPD patients

Figures & data

Table 1 Patient demographics and clinical outcomes

Number of males/females: 208/158 (ratio 1.3:1)

Mean age: 72.7 years (±12.1 SD)

Mean length of stay: 5.1 days (±5.5 SD)

Median length of stay: 3 days (interquartile range =2–6)

Number of ICU admissions: 7 (1.9%)

Number of deaths: 11 (3.0%)

Abbreviation: ICU, intensive care unit.

Figure 1 CONSORT diagram.

Note: Text/data shown in bold are the important points.
Abbreviation: BB, beta-blocker.

Table 2 Indications and contraindications for beta-blocker use

	Percentage of patients, % (n=366)
Indications
Ischemic heart disease	33.1 (121)
Congestive cardiac failure	15.8 (58)
Tachyarrhythmias	11.2 (41)
At least 1 indication	42.6 (156)
More than 1 indication	15.0 (55)
Contraindications
Beta-blocker allergy	0.3 (1)
Asthma	17.8 (65)
Peripheral vascular disease	5.7 (21)
Bradyarrhythmias	7.7 (28)
Hypotension	3.0 (11)
At least 1 contraindication	31.7 (116)

Note: Values shown in bold are the important points.

Table 3 Prevalent use of cardiovascular drugs in AECOPD patients

	Beta-blocker, %	Anti-platelet drug, %	Statin, %	ACEi/ARB, %
% baseline use in all AECOPD patients (n=366)	19.7	45.6	39.6	45.9
% prevalent use in patients with incident IHD events (n=25)	16	48	44	44
% prevalent use in patients with previous history of IHD (n=16)	25	75	68.8	68.8

Abbreviations: ACEi, angiotensin converting enzyme inhibitor; AECOPD, acute exacerbation of chronic obstructive pulmonary disease; ARB, angiotensin II receptor blocker; IHD, ischemic heart disease.

Table 4 Initiation of cardiovascular drugs in AECOPD patients with new IHD events

n=25	Beta- blocker	Anti-platelet drug	Statin	ACEi/ARB
% incident initiation of therapy in treatment-naïve patients	14.3% (3 of 21)	76.9% (10 of 13)	28.6% (4 of 14)	14.3% (2 of 14)

Abbreviations: ACEi, angiotensin converting enzyme inhibitor; AECOPD, acute exacerbation of chronic obstructive pulmonary disease; ARB, angiotensin II receptor blocker; IHD, ischemic heart disease.

Figure 2 Clinical endpoints for AECOPD patients stratified by incidence of cardiovascular or cerebrovascular events.

Abbreviations: AECOPD, acute exacerbation of chronic obstructive pulmonary disease; CVS, cardiovascular; CVA, cerebrovascular; ICU, intensive care unit.