Commencement of cardioselective beta-blockers during hospitalisation for acute exacerbations of chronic obstructive pulmonary disease

AuthorsNeef, PA
Burrell, LM
McDonald, CF
Irving, LB
Johnson, DF
Steinfort, DP
TypeAccepted for Publication
JournalInternal Medicine Journal
Year of Publication2017
URLhttp://onlinelibrary.wiley.com/wol1/doi/10.1111/imj.13518/abstract
DOIhttp://dx.doi.org/10.1111/imj.13518
AbstractBackground 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

http://www.ibas.org.au/what-we-do/publications/3872918


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