Discharge β-blocker use and race after coronary artery bypass grafting

Journal Article (Journal Article)

Introduction: The use of discharge β-blockers after cardiac surgery is associated with a long-term mortality benefit. b-Blockers have been suggested to be less effective in black cardiovascular patients compared with whites. To date, racial differences in the long-term survival of coronary artery bypass grafting (CABG) patients who receive β-blockers at discharge have not been examined. Methods: A retrospective cohort study was conducted on patients undergoing CABG between 2002 and 2011. Long-term survival was compared in patients who were and who were not discharged with β-blockers. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model. P-for-interaction between race and discharge b-blocker use was computed using a likelihood ratio test. Results:A total of 853 (88%) black (nD970) and 3,038 (88%) white (nD3,460) patients had a history of b-blocker use at discharge (N D4,430). Black patients who received β-blockers survived longer than those not receiving β-blockers and the survival advantage was comparable with white patients (black, adjusted HRD0.33, 95% CID0.23-0.46; white, adjusted HRD0.48, 95% CID0.39-0.58; p-for-interactionD0.74). Among patients discharged on β-blockers, we did not observe a long-term survival advantage for white compared with black patients (HRD1.2, 95% CID0.95-1.5). Conclusion: b-Blocker use at discharge was associated with a survival advantage among black patients after CABG and a similar association was observed in white patients.

Full Text

Duke Authors

Cited Authors

  • O'Neal, WT; Efird, JT; Davies, SW; O'Neal, JB; Griffin, WF; Ferguson, TB; Chitwood, WR; Kypson, AP

Published Date

  • July 29, 2014

Published In

Volume / Issue

  • 2 / JUL

Electronic International Standard Serial Number (EISSN)

  • 2296-2565

Digital Object Identifier (DOI)

  • 10.3389/fpubh.2014.00094

Citation Source

  • Scopus