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Baseline characteristics and outcomes of patients with heart failure receiving bronchodilators in the CHARM programme.

Publication ,  Journal Article
Hawkins, NM; Wang, D; Petrie, MC; Pfeffer, MA; Swedberg, K; Granger, CB; Yusuf, S; Solomon, SD; Ostergren, J; Michelson, EL; Pocock, SJ ...
Published in: Eur J Heart Fail
June 2010

AIMS: Heart failure (HF) and chronic obstructive pulmonary disease are common partners. Bronchodilators are associated with adverse cardiovascular outcomes in patients with pulmonary disease. The outcome of patients with HF prescribed bronchodilators is poorly defined. METHODS AND RESULTS: The Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme randomized 7599 patients with symptomatic HF to receive candesartan or placebo. The relative risk conveyed by bronchodilator therapy was examined using a multivariable Cox proportional hazards model. The prevalence of bronchodilator therapy was similar in patients with reduced and preserved systolic function (respectively, 8.7 vs. 9.2%, P = 0.46). Beta-blocker utilization was markedly lower in patients receiving bronchodilators compared with those without (overall 31.9 vs. 57.6%, P < 0.0001). Bronchodilator use was associated with increased all-cause mortality [HR 1.26 (1.09-1.45), P = 0.0015], cardiovascular death [HR 1.21 (1.03-1.42), P = 0.0216], HF hospitalization [HR 1.49 (1.29-1.72), P < 0.0001], and major adverse cardiovascular events [HR 1.32 (1.17-1.76), P < 0.0001]. The adverse outcomes were consistent in patients with reduced and preserved systolic function. No significant interaction was observed between bronchodilators and beta-blockade with respect to outcomes. CONCLUSION: Bronchodilator use is a powerful independent predictor of worsening HF and increased mortality in a broad spectrum of patients with HF. Whether this relates to a toxic effect of bronchodilators, underlying pulmonary disease, or both is unclear and warrants further investigation.

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Published In

Eur J Heart Fail

DOI

EISSN

1879-0844

Publication Date

June 2010

Volume

12

Issue

6

Start / End Page

557 / 565

Location

England

Related Subject Headings

  • Tetrazoles
  • Pulmonary Disease, Chronic Obstructive
  • Proportional Hazards Models
  • Prognosis
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Female
  • Comorbidity
 

Citation

APA
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ICMJE
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Hawkins, N. M., Wang, D., Petrie, M. C., Pfeffer, M. A., Swedberg, K., Granger, C. B., … CHARM Investigators and Committees, . (2010). Baseline characteristics and outcomes of patients with heart failure receiving bronchodilators in the CHARM programme. Eur J Heart Fail, 12(6), 557–565. https://doi.org/10.1093/eurjhf/hfq040
Hawkins, Nathaniel M., Duolao Wang, Mark C. Petrie, Marc A. Pfeffer, Karl Swedberg, Christopher B. Granger, Salim Yusuf, et al. “Baseline characteristics and outcomes of patients with heart failure receiving bronchodilators in the CHARM programme.Eur J Heart Fail 12, no. 6 (June 2010): 557–65. https://doi.org/10.1093/eurjhf/hfq040.
Hawkins NM, Wang D, Petrie MC, Pfeffer MA, Swedberg K, Granger CB, et al. Baseline characteristics and outcomes of patients with heart failure receiving bronchodilators in the CHARM programme. Eur J Heart Fail. 2010 Jun;12(6):557–65.
Hawkins, Nathaniel M., et al. “Baseline characteristics and outcomes of patients with heart failure receiving bronchodilators in the CHARM programme.Eur J Heart Fail, vol. 12, no. 6, June 2010, pp. 557–65. Pubmed, doi:10.1093/eurjhf/hfq040.
Hawkins NM, Wang D, Petrie MC, Pfeffer MA, Swedberg K, Granger CB, Yusuf S, Solomon SD, Ostergren J, Michelson EL, Pocock SJ, Maggioni AP, McMurray JJV, CHARM Investigators and Committees. Baseline characteristics and outcomes of patients with heart failure receiving bronchodilators in the CHARM programme. Eur J Heart Fail. 2010 Jun;12(6):557–565.
Journal cover image

Published In

Eur J Heart Fail

DOI

EISSN

1879-0844

Publication Date

June 2010

Volume

12

Issue

6

Start / End Page

557 / 565

Location

England

Related Subject Headings

  • Tetrazoles
  • Pulmonary Disease, Chronic Obstructive
  • Proportional Hazards Models
  • Prognosis
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Female
  • Comorbidity