|Type||Accepted for Publication|
|Journal||Internal Medicine Journal|
|Year of Publication||2017|
|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|
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