Abstract 079: Nebivolol Associated With Reduced Incident Cardiovascular Events In Hypertensive Patients Compared With Non-vasodilatory Beta Blockers

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Daniel M Huck ◽  
Michael A Rosenberg ◽  
Michael R Bristow ◽  
Brian L Stauffer
Keyword(s):  
Logistic Regression ◽  
Beta Blocker ◽  
Cardiovascular Events ◽  
Primary Outcome ◽  
Beta Blockers ◽  
Coronary Revascularization ◽  
Cohort Analysis ◽  
Cardiovascular Outcomes ◽  
Hypertensive Patients ◽  
Propensity Matching

Introduction: Beta blockers are not guideline-recommended first-line agents for hypertension, based on evidence that older generation beta blockers such as atenolol are associated with inferior reduction of some cardiovascular events compared to other antihypertensive classes. Vasodilatory beta blockers such as nebivolol have been found to have beneficial effects on peripheral vasculature through nitric oxide, endothelin-1, and tissue plasminogen activator pathways. The objective of this study is to compare longitudinal cardiovascular outcomes of hypertensive patients taking the vasodilatory beta blocker nebivolol with hypertensive patients taking the non-vasodilatory beta blockers atenolol and metoprolol. Hypothesis: Nebivolol will be associated with a reduction in odds of adverse cardiovascular outcomes compared with non-vasodilatory beta blockers. Methods: The study is a retrospective cohort analysis of de-identified data from adults in the University of Colorado health system with hypertension and on the vasodilatory beta blocker nebivolol or the non-vasodilatory beta blockers atenolol or metoprolol, without preceding diagnosis of cardiovascular or cerebrovascular disease. The primary outcome is incident cardiovascular hospitalization or diagnosis of cardiovascular event including heart failure, stroke, myocardial infarction, angina pectoris, or coronary revascularization based on diagnosis or procedure codes. Nearest-available propensity matching logistic regression was used, with each patient taking nebivolol matched to two control patients taking a non-vasodilatory beta blocker. Propensity matching variables included baseline demographics, cardiovascular risk factors, Charlson comorbidity index, other cardiovascular medications, and duration of follow-up. Results: There were 1395 patients taking nebivolol, and 20208 patients taking atenolol or metoprolol. Patients were predominantly female (54%, 11681 of 21603) and non-Hispanic white (75%, 16185 of 21603), with mean age of 60. The primary outcome occurred in 19% (259 of 1395) of those taking nebivolol, 29% (1891 of 6527) of those taking atenolol, and 40% (5500 of 13681) of those taking metoprolol. In propensity matched logistic regression, nebivolol is associated with reduced odds of incident cardiovascular events when compared to the non-vasodilatory beta blockers atenolol and metoprolol (OR 0.33, 95% CI 0.28 to 0.40). This association was also found with individual comparison with atenolol (OR 0.47, 95% CI 0.39 to 0.57) and metoprolol (OR 0.26, 95% CI 0.21 to 0.32). Conclusions: The vasodilatory beta blocker nebivolol is associated with reduced odds of incident cardiovascular events compared to non-vasodilatory beta blockers. Additional study of other beta blockers is necessary to determine if this is a vasodilatory beta blocker class effect, or is specific to nebivolol.

scholarly journals Beta-blocker use is associated with prevention of left ventricular remodeling in recovered dilated cardiomyopathy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Enzan ◽  
S Matsushima ◽  
T Ide ◽  
H Kaku ◽  
T Higo ◽  
...  
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Beta Blocker ◽  
Primary Outcome ◽  
Protocol Analysis ◽  
Beta Blockers ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Funding Source ◽  
Ventricular Ejection Fraction

Abstract Background Withdrawal of optimal medical therapy has been reported to relapse cardiac dysfunction in patients with dilated cardiomyopathy (DCM) whose cardiac function had improved. However, it is unknown whether beta-blockers can prevent deterioration of cardiac function in those patients. Purpose We examined the effect of beta-blockers on left ventricular ejection fraction (LVEF) in recovered DCM. Methods We analyzed the clinical personal records of DCM, a national database of Japanese Ministry of Health, Labor and Welfare, between 2003 and 2014. Recovered DCM was defined as a previously documented LVEF <40% and a current LVEF ≥40%. Patients with recovered DCM were divided into two groups according to the use of beta-blockers. The primary outcome was defined as a decrease in LVEF >10% at two years of follow-up. A one to one propensity case-matched analysis was used. A per-protocol analysis was also performed. Considering intra- and inter-observer variability of echocardiographic evaluations, we also examined outcomes by multivariable logistic regression model after changing the inclusion criteria as follows; (1) previous LVEF <40% and current LVEF ≥40%; (2) previous LVEF <35% and current LVEF ≥40%; (3) previous LVEF <30% and current LVEF ≥40%; (4) previous LVEF <40% and current LVEF ≥50%. Outcomes were also changed as (1) decrease in LVEF ≥5% (2) decrease in LVEF ≥10% (3) decrease in LVEF ≥15%. The analysis of outcomes by using combination of multiple imputation and inverse probability of treatment weighting was also conducted to assess the effects of missing data and selection bias attributable to propensity score matching on outcomes. Results From 2003 to 2014, 40,794 consecutive patients with DCM were screened. Out of 5,338 eligible patients, 4,078 received beta-blockers. Propensity score matching yielded 998 pairs. Mean age was 61.7 years and 1,497 (75.0%) was male. Mean LVEF was 49.1±8.1%. The primary outcome was observed less frequently in beta-blocker group than in no beta-blocker group (18.0% vs. 23.5%; odds ratio [OR] 0.72; 95% confidence interval [CI] 0.58–0.89; P=0.003). The prevalence of increases in LVDd (11.5% vs. 15.8%; OR 0.70; 95% CI 0.54–0.91; P=0.007) and LVDs (23.1% vs. 27.2%; OR 0.80; 95% CI 0.65–0.99; P=0.041) was also lower in the beta-blocker group. Similar results were obtained in per-protocol analysis. These results were robust to several sensitivity analyses. As a result of preventing a decrease in LVEF, the deterioration to HFrEF was also prevented by the use of beta-blocker (23.6% vs. 30.6%). Subgroup analysis demonstrated that beta-blocker prevented decrease in LVEF regardless of atrial fibrillation. Conclusion Use of beta-blocker was associated with prevention of decrease in left ventricular ejection fraction in patients with recovered DCM. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Health Sciences Research Grants from the Japanese Ministry of Health, Labour and Welfare (Comprehensive Research on Cardiovascular Diseases)

P6424The association between long-term beta-blocker use and outcome in a contemporary large-scale cohort of patients with acute myocardial infarction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C X Song ◽  
R Fu ◽  
J G Yang ◽  
K F Dou ◽  
Y J Yang
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Beta Blocker ◽  
Cardiovascular Events ◽  
Beta Blockers ◽  
Left Ventricular Ejection ◽  
Major Adverse Cardiovascular Events ◽  
Baseline Characteristics

Abstract Background Controversy exists regarding the use of beta-blockers (BBs) among patients with acute myocardial infarction (AMI) in contemporary reperfusion era. Previous studies predominantly focused on beta-blockers prescribed at discharge, and the effect of long-term adherence to beta-blocker on major adverse cardiovascular events (MACE) remains unclear. Objective To explore the association between long-term beta-blocker use patterns and MACE among contemporary AMI patients. Methods We enrolled 7860 patients with AMI, who were discharged alive and prescribed with BBs based on CAMI registry from January 2013 to September 2014. Patients were divided into two groups according to BBs use pattern: Always users group (n=4476) were defined as patients reporting BBs use at both 6- and 12-month follow-up; Inconsistent users group were defined as patients reporting at least once not using BBs at 6- or 12-month follow-up. Primary outcome was defined as MACE at 24-month follow-up, including all-cause death, non-fatal MI and repeat-revascularization. Multivariable cox proportional hazards regression model was used to assess the association between BBs and MACE. Results Baseline characteristics are shown in table 1. At 2-year follow-up, 518 patients in inconsistent users group (15.6%) and 548 patients in always users group (12.3%) had MACE. After multivariable adjustment, inconsistent use of BBs was associated with higher risk of MACE (HR: 1.323, 95% CI: 1.171–1.493, p<0.001). Table 1 Baseline characteristics Variable Always user (N=4476) Inconsistent user (N=3384) P value Age (years) 60.6±12.0 61.2±12.2 <0.001 Male 3381 (75.7%) 2461 (74.3%) 0.084 Diabetes 892 (20.0%) 610 (18.4%) 0.003 Hypertension 2372 (53.2%) 1543 (46.6%) <0.001 Dyslipidemia 244 (5.5%) 126 (3.8%) <0.001 Prior myocardial infarction 351 (7.9%) 232 (7.0%) <0.001 Heart failure 88 (2.0%) 63 (1.9%) <0.001 Chronic obstructive pulmonary disease 66 (1.5%) 60 (1.8%) <0.001 Current smoker 2054 (46.1%) 1579 (47.8%) 0.179 Left ventricular ejection fraction (%) 53.7±11.48 54.0±10.9 <0.001 Major Adverse Cardiovascular Events 548 (12.3%) 518 (15.6%) <0.001 Conclusions Our results showed consistent BBs use was associated with reduced risk of MACE among patients with AMI managed by contemporary treatment. Acknowledgement/Funding CAMS Innovation Fund for Medical Sciences (CIFMS) (2016-I2M-1-009)

Abstract 9839: Beta Blockers Improve Renal Tissue Oxygenation in Hypertensive Patients Suspected of Renal Artery Stenosis

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Michael E Hall ◽  
Michael V Rocco ◽  
Timothy M Morgan ◽  
Craig A Hamilton ◽  
Jennifer H Jordan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Beta Blocker ◽  
Tissue Oxygenation ◽  
Beta Blockers ◽  
Renal Tissue ◽  
Artery Stenosis ◽  
Blocker Therapy ◽  
Hypertensive Patients

Background: Chronic renal hypoxia influences the progression of chronic kidney disease (CKD). Blood oxygen level dependent (BOLD) magnetic resonance (MR) is a noninvasive tool for assessment of renal tissue oxygenation. Beta blockers reduce cardiovascular mortality in patients with CKD and systolic heart failure, however the mechanisms of this benefit remain unclear. We sought to determine the association between beta blocker use, renal cortical and medullary oxygenation, and renal blood flow in hypertensive patients suspected of renal artery stenosis. Hypothesis: Chronic receipt of beta blockers will be associated with improved renal tissue oxygenation as assessed by BOLD MR. Methods: We measured renal cortical and medullary oxygenation using BOLD MR and renal artery blood flow using MR phase contrast techniques in 38 participants suspected of renal artery stenosis. Results: Chronic beta blocker therapy was associated with improved renal cortical (p=0.0007) and medullary (p=0.03) oxygenation (Figure). Receipt of angiotensin converting enzyme inhibitors or angiotensin receptor blockers was associated with reduced medullary oxygenation (p=0.01). In a multivariable model including gender, hemoglobin, diabetes, loop diuretic use, and mineralocorticoid use, chronic receipt of beta blockers was the only significant predictor of renal tissue oxygenation (β= 8.4, p=0.008). Conclusions: Beta blocker therapy was associated with improved renal oxygenation independent of renal blood flow suggesting may these findings may be related to reduced renal oxygen consumption. In addition to their known benefits to reduce cardiovascular mortality in patients with renal disease, beta blockers may reduce or prevent progression of renal dysfunction in patients with hypertension, diabetes, and renovascular disease. These observations may have important implications for treatment of patients with CKD.

Abstract 3734: Glucose-Insulin-Potassium Infusion in Patients with Acute Myocardial Infarction treated with Reperfusion Therapy Does Not Reduce the Risk of Cardiovascular Events: A Pooled Meta-analysis of Randomized Controlled Trials

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Srikanth Katragadda ◽  
Sandeep A Saha ◽  
Rohit R Arora
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiovascular Events ◽  
Coronary Revascularization ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Reperfusion Therapy ◽  
Cardiovascular Outcomes ◽  
Controlled Trials ◽  
Risk Of Death

Background: Metabolic modulation of ischemic myocardium using a glucose-insulin-potassium (GIK) infusion has been studied in patients with acute myocardial infarction treated with reperfusion therapy, but the results have been conflicting. We conducted a systematic review and meta-analysis of randomized placebo-controlled trials evaluating the utility of GIK in the prevention of adverse cardiovascular outcomes in patients with acute myocardial infarction who underwent reperfusion therapy. Methods: A total of 19,222 patients from 6 randomized placebo-controlled clinical trials were analyzed using pooled meta-analysis techniques, and relative risks at the end of one month were computed for various adverse cardiovascular outcomes. Statistical significance was determined using the z -test (two-sided alpha-error <0.05). Results: The use of GIK did not significantly reduce the risk of death within the first month among patients with acute myocardial infarction treated with reperfusion therapy (p=0.40), and did not differ among those treated with thrombolytic agents (p=0.54) or those treated with primary coronary angioplasty (p=0.38). The risk of re-infarction within the first month was also not significantly reduced (p=0.32), nor were the risk of development of heart failure (p=0.40) or the need for invasive coronary revascularization (p=0.76). Conclusions: Among patients with acute myocardial infarction who are treated with reperfusion therapy, the use of GIK infusion has no significant effect on mortality or the occurrence of adverse cardiovascular events within the first month.

scholarly journals Beta‐Blocker Use Is Associated With Prevention of Left Ventricular Remodeling in Recovered Dilated Cardiomyopathy

2021 ◽  
Author(s):  
Nobuyuki Enzan ◽  
Shouji Matsushima ◽  
Tomomi Ide ◽  
Hidetaka Kaku ◽  
Takeshi Tohyama ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Dilated Cardiomyopathy ◽  
Beta Blocker ◽  
Primary Outcome ◽  
Ventricular Remodeling ◽  
Beta Blockers ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
National Database ◽  
Ventricular Ejection Fraction

Background Withdrawal of optimal medical therapy has been reported to relapse cardiac dysfunction in patients with dilated cardiomyopathy (DCM) whose cardiac function had improved. However, it is unknown whether beta‐blockers can prevent deterioration of cardiac function in those patients. We examined the effect of beta‐blockers on left ventricular ejection fraction (LVEF) in recovered DCM. Methods and Results We analyzed the clinical personal record of DCM, a national database of the Japanese Ministry of Health, Labor and Welfare, between 2003 and 2014. Recovered DCM was defined as a previously documented LVEF <40% and a current LVEF ≥40%. Patients with recovered DCM were divided into 2 groups according to the use of beta‐blockers. A one‐to‐one propensity case‐matched analysis was used. The primary outcome was defined as a decrease in LVEF >10% at 2 years of follow‐up. Of 5370 eligible patients, 4104 received beta‐blockers. Propensity score matching yielded 1087 pairs. Mean age was 61.9 years, and 1619 (74.5%) were men. Mean LVEF was 49.3±8.2%, and median B‐type natriuretic peptide was 46.6 (interquartile range, 18.0–118.1) pg/mL. The primary outcome was observed less frequently in the beta‐blocker group than in the no‐beta‐blocker group (19.6% versus 24.0%; odds ratio [OR], 0.77; 95% CI, 0.63–0.95; P =0.013). Subgroup analysis demonstrated that female patients (women: OR, 0.54; 95% CI, 0.36–0.81; men: OR, 0.88; 95% CI, 0.69–1.12; P for interaction=0.040) were benefited by beta‐blockers. Conclusions Beta‐blocker use could prevent deterioration of left ventricular systolic function in patients with recovered DCM.

P1252ASSOCIATIONS OF SERUM SCLEROSTIN AND DKK-1 PROTEIN WITH FUTURE CARDIOVASCULAR EVENTS AND MORTALITY IN HEMODIALYSIS PATIENTS; A PROSPECTIVE COHORT STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
EIRINI STAVRINOU ◽  
Panteleimon Sarafidis ◽  
Charalampos Loutradis ◽  
Evangelos Memmos ◽  
Danai Faitatzidou ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Primary Outcome ◽  
Cox Regression ◽  
Coronary Revascularization ◽  
Prognostic Significance ◽  
Decompensated Heart Failure ◽  
Hemodialysis Patients ◽  
High Serum ◽  
All Cause Mortality ◽  
Cardiovascular Endpoint

Abstract Background and Aims Sclerostin and Dickkopf-1 (Dkk-1) protein are inhibitors of the canonical Wnt/β-catenin bone pathway. Sclerostin but not Dkk-1 is associated with increased arterial stiffness. This study examined the prognostic significance of serum sclerostin and Dickkopf-related protein-1 (Dkk-1) levels for cardiovascular outcomes and mortality in hemodialysis patients. Method Serum sclerostin and Dkk-1 levels were measured with ELISA in 80 hemodialysis patients that were followed-up for a median of 45 months. Several factors that could interfere in the association of sclerostin and Dkk-1 with outcomes (including carotid-femoral pulse-wave-velocity (PWV), parathyroid hormone, calcium-phospate product and others) were assessed at baseline The primary end-point was a combination of all-cause death, non-fatal myocardial infarction, non-fatal stroke, coronary revascularization, hospitalization for decompensated heart failure and new-onset atrial fibrillation. Secondary end-points included cardiovascular and all-cause mortality. Results Cumulative freedom from the primary endpoint was significantly lower for higher tertiles of sclerostin (77.8%, 69.2%, and 40.7% for tertiles 1 to 3 respectively; log-rank-p=0.004). The corresponding risk for the primary outcome was gradually increasing for higher tertiles of sclerostin (Tertile 3: HR: 3.847, 95%CI: 1.502-9.851). No significant association was evident between sclerostin and all-cause mortality, whereas higher sclerostin levels presented a trend towards higher risk for cardiovascular mortality. Dkk-1 levels exhibited no association with the risk of the primary or the secondary endpoints. In stepwise Cox regression modeled analysis, sclerostin levels were associated with the primary outcome, independently of PTH, calcium-phosphate product, serum albumin, CRP and PWV levels (HR: 2.921, 95%CI: 1.401–6.090; p=0.004). Conclusion High serum sclerostin levels are associated with lower cumulative freedom and higher risk for a composite cardiovascular endpoint but not for all-cause mortality. Dkk-1 protein exhibited no association with the future risk of cardiovascular events.

scholarly journals Association between topical beta-blockers and risks of cardiovascular and respiratory disease in patients with glaucoma: a retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e034361 ◽  
Author(s):  
Hsin-Yi Chen ◽  
Wei-Cheng Huang ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Ischaemic Stroke ◽  
Beta Blocker ◽  
Retrospective Cohort ◽  
Respiratory Diseases ◽  
Beta Blockers ◽  
Cohort Analysis ◽  
Multiplicative Interaction ◽  
Age And Sex

ObjectiveTo determine if topical beta-blocker use is associated with increased risks of cardiovascular and respiratory diseases in patients with glaucoma.SettingA retrospective cohort analysis was conducted using the database from Taiwan’s National Health Insurance programme.ParticipantsIn total, 12 336 newly diagnosed patients with glaucoma from January 2000 to December 2010 were included. The patients with glaucoma were subdivided into two cohorts according to whether they used topical beta-blockers or combination drugs (BBCDs).Primary outcome measuresThe study endpoints included pneumonia, acute respiratory failure, stroke and coronary artery disease (CAD). Univariable and multivariable Cox proportional hazards regression models were used to estimate HRs and 95% CIs for the endpoints of both cohorts.ResultsThe BBCD cohort had a slightly higher risk of acute respiratory failure (adjusted HRs=1.16, 95% CI 1.00 to 1.34) and lower risk of CAD (aHR=0.93, 95% CI 0.87 to 0.99) than the non-BBCD cohort. Additionally, the risk of stroke was significantly higher in BBCD cohort than in the non-BBCD cohort (aHR=1.39, 95% CI 1.23 to 1.58), especially the ischaemic stroke (aHR=1.44, 95% CI 1.26 to 1.64; aHR=1.44, 98.75% CI 1.21 to 1.71). After considering the multiplicative interaction of age and sex, the BBCD cohort do not have higher risk of all outcomes than the non-BBCD cohort. Further time-dependent regression analysis revealed BBCD cohort had higher risk of acute respiratory failure (aHR=1.17, 95% CI 1.01 to 1.35) and ischaemic stroke (aHR=1.44, 95% CI 1.26 to 1.65) than non-BBCD cohort. However, after considering the multiplicative interaction of age and sex, the BBCD cohort had no significantly higher risk of all outcomes than the non-BBCD cohort.ConclusionTopical beta-blocker is not associated with increased risks of cardiovascular and respiratory diseases in patients with glaucoma.

scholarly journals Erythropoiesis-Stimulating Agents in Elderly Patients with Anemia of Unknown Etiology: Treatment Response and Cardiovascular Outcomes

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 1267-1267
Author(s):  
Zachary Gowanlock ◽  
Swetha Sriram ◽  
Alison Martin ◽  
Anargyros Xenocostas ◽  
Alejandro Lazo-Langner
Keyword(s):  
Logistic Regression ◽  
Treatment Response ◽  
Cardiovascular Event ◽  
Odds Ratio ◽  
Cardiovascular Events ◽  
Regression Models ◽  
Cox Regression ◽  
Cardiovascular Outcomes ◽  
Unknown Etiology ◽  
Hazard Ratios

Abstract Background: Anemia of unknown etiology (AUE) is a common category of anemia in the elderly where investigations cannot identify a specific cause. We have previously shown that AUE patients exhibit lower erythropoietin (EPO) levels which may be associated with either decreased EPO production or a blunted EPO response to anemia. Erythropoiesis-stimulating agents (ESAs) mimic the effect of endogenous EPO and may play a role in treating AUE. In this study, we investigated the response to ESA treatment in patients with AUE compared to other causes of anemia. We also examined the effect of ESAs on cardiovascular outcomes in our cohort. To our knowledge, no previous study has specifically assessed ESAs in AUE. Patients and methods: We conducted a retrospective cohort study including all consecutive hematology patients referred to our centre and who had EPO levels determined between 2005 and 2013. We included patients 60 years or older who met the World Health Organization criteria for anemia (hemoglobin [Hb] <130 g/L in men, <120 g/L in women) excluding patients with insufficient electronic medical records. The cohort was subdivided into a group treated with ESAs and an untreated group. Three reviewers independently adjudicated each patient's anemia to one of four diagnostic groups: chronic kidney disease (CKD), myelodysplastic syndrome (MDS), AUE, or other miscellaneous etiologies. The etiology reported by at least two of the three reviewers was used in the analysis, with differences resolved by consensus. Inter-observer agreement was assessed using Fleiss' Kappa statistic. Treatment response was defined by at least a 15 g/L increase in the Hb level from baseline, or a decrease of at least 4 transfusions over 8 weeks, compared to pretreatment. We performed logistic regression to measure the association between the anemia etiology and treatment response while controlling for the following potential confounders: sex, age, weight, Charlson's comorbidity index, Hb, EPO level, estimated glomerular filtration rate (eGFR), and the presence of additional cytopenias. To evaluate safety we identified each documented cardiovascular event in the cohort including ischemic stroke, myocardial infarction, pulmonary embolism, deep vein thrombosis or portal vein thrombosis. We generated Kaplan-Meier curves comparing cardiovascular events and cardiovascular event-free survival between the treated and untreated groups. Hazard ratios were calculated using Cox regression analysis. Results: The inclusion criteria were met by 570 of 1511 potentially eligible patients. Of the 113 patients treated with an ESA, data was adequate to assess treatment response in 101 patients. Of the patients treated with an ESA, the mean age was 75.1 years and 60% were male. The mean pretreatment hemoglobin was 88.5 g/L. Inter-observer agreement for diagnostic categories was adequate. Eighty-two patients were treated with epoetin alfa and 19 patients received darbepoetin alfa. Treatment response was better in the CKD and AUE groups (54% and 47%, respectively) compared to the other groups. Compared to the group of other etiologies logistic regression analysis showed a 3.6 and 3.3 adjusted odds ratio (OR) for response for CKD and AUE respectively, although this was not statistically significant (Table 1). A baseline EPO level <200 IU/L was associated with a response to ESAs (OR 9.3; 95% CI 1.1-75.4). There was no significant difference in cardiovascular events or cardiovascular event-free survival between the treated and untreated groups, even after adjusting for confounders (Table 2). Conclusion: Our results suggest that ESAs can be used to treat anemia of unknown etiology, and responses may be similar to those in chronic kidney disease. This supports the notion that a relative EPO deficiency is probably related to the pathogenesis of AUE. Although treatment may be associated with increased cardiovascular events, this was not found to be significant in our cohort. Limitations of this study include its retrospective nature and a relatively small sample size. Further studies exploring the safety and efficacy of ESAs in the treatment of AUE are warranted. Table 1 Odds ratio of treatment response in unadjusted and adjusted logistic regression models Table 1. Odds ratio of treatment response in unadjusted and adjusted logistic regression models Table 2 Hazard ratios for cardiovascular outcomes in patients receiving ESAs in unadjusted and adjusted Cox regression models Table 2. Hazard ratios for cardiovascular outcomes in patients receiving ESAs in unadjusted and adjusted Cox regression models Disclosures Xenocostas: Janssen Inc.: Research Funding. Lazo-Langner:Daiichi Sankyo: Research Funding; Pfizer: Honoraria; Bayer: Honoraria.

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