Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/16675
Title: Commencement of cardioselective beta-blockers during hospitalisation for acute exacerbations of chronic obstructive pulmonary disease
Austin Authors: Neef, Pieter A ;Burrell, Louise M ;McDonald, Christine F ;Irving, Louis B;Johnson, Douglas F;Steinfort, Daniel P
Affiliation: Department of General Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine and Cardiology, University of Melbourne, Parkville, Victoria, Australia
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
Department of Respiratory and Sleep Medicine, Melbourne Health, Parkville, Victoria, Australia
Issue Date: Sep-2017
metadata.dc.date: 2017-06-13
Publication information: 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.
URI: http://ahro.austin.org.au/austinjspui/handle/1/16675
DOI: 10.1111/imj.13518
ORCID: 0000-0003-1863-7539
0000-0001-6481-3391
0000-0002-7143-7387
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/28608512
Type: Journal Article
Subjects: Acute exacerbation of COPD
Beta-blocker
Cardiovascular disease
Chronic obstructive pulmonary disease
Safety
Appears in Collections:Journal articles

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