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Title: Commencement of cardioselective beta-blockers during hospitalisation for acute exacerbations of chronic obstructive pulmonary disease
Authors: Neef, Pieter A;Burrell, Louise M;McDonald, Christine F;Irving, Louis B;Johnson, Douglas F;Steinfort, Daniel P
Issue Date: Sep-2017
EDate: 2017-06-13
Citation: Internal Medicine Journal 2017; 47(9): 1043-1050
Abstract: BACKGROUND: In patients with chronic obstructive pulmonary disease (COPD) and comorbid cardiovascular disease emerging evidence suggests a benefit in commencing cardioselective beta-blockers. AIM: Our objective was to determine the safety of beta-blocker commencement during hospitalisation for acute exacerbation of COPD. METHODS: A retrospective cohort study of 1,071 patients hospitalised for acute exacerbation of COPD was conducted across two tertiary hospitals over a 12-month period. We identified 36 patients in whom beta-blocker therapy was commenced during admission. Primary outcome of the study was to assess cardiovascular and respiratory adverse events related to the commencement of beta-blocker therapy. RESULTS: The most common indications for beta-blockers were atrial fibrillation (53%) and acute coronary syndrome (36%). Metoprolol was the most commonly prescribed beta-blocker (75%). No patients suffered clinically significant decline of respiratory function following the commencement of a beta-blocker, including worsening respiratory symptoms, oxygen, bronchodilator or ventilation requirements. These results were demonstrable in patients with reversible airways disease and advanced COPD. Only one patient (2.8%) experienced symptomatic hypotension after 48 hours of therapy. CONCLUSION: The commencement of cardio-selective beta-blockers during acute exacerbations of COPD appears to be well-tolerated.
DOI: 10.1111/imj.13518
ORCID: 0000-0003-1863-7539
PubMed URL:
Type: Journal Article
Subjects: Acute exacerbation of COPD
Cardiovascular disease
Chronic obstructive pulmonary disease
Appears in Collections:Journal articles

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