Abstract: FR-PO753
Comparison of Beta Blocker Outcomes Among CKD Patients With Cardiorenal Syndrome
Session Information
- Hypertension and CVD: Clinical, Outcomes, Trials
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1502 Hypertension and CVD: Clinical‚ Outcomes‚ and Trials
Authors
- Yu, Albert, Kaiser Permanente Southern California, Los Angeles, California, United States
- Zhou, Hui, Kaiser Permanente Southern California, Los Angeles, California, United States
- Pak, Katherine J., Kaiser Permanente Southern California, Los Angeles, California, United States
- Shaw, Sally F., Kaiser Permanente Southern California, Los Angeles, California, United States
- Shi, Jiaxiao, Kaiser Permanente Southern California, Los Angeles, California, United States
- Broder, Benjamin, Kaiser Permanente Southern California, Los Angeles, California, United States
- Huang, Cheng-Wei, Kaiser Permanente Southern California, Los Angeles, California, United States
- Sim, John J., Kaiser Permanente Southern California, Los Angeles, California, United States
Background
Beta blockers reduce mortality and hospitalization in patients with heart failure with reduced ejection fraction (HFrEF). The three guideline directed medical therapy (GDMT) beta blockers are bisoprolol, carvedilol, and metoprolol succinate, however, their effects in chronic kidney disease (CKD) patients are not well studied. We compared one year outcomes among these three GDMT beta blockers in the patients with both HFrEF and CKD.
Methods
A retrospective study was performed within Kaiser Permanente Southern California (KPSC) during 2007-2017 among patients with incident advanced CKD (eGFR<45) who had prevalent HFrEF. We limited the study population to the patients who were taking GDMT beta blockers at baseline and followed them for one year to assess outcomes including major adverse cardiac events (MACE), renal events, all-cause death, and all-cause hospitalization. Multiple models were performed to estimate hazard ratio (HR) or rate ratio (RR) of these outcomes after adjustment for potential confounders or potential competing risk, respectively.
Results
A total of 2,355 (16.9%) among incident CKD patients had HFrEF and were treated with GDMT beta blockers. Within one year, 30.3% patients had encountered MACE, 52.2% had ≥ 1 hospitalization and 22.8% died with cardiovascular death accounting for 19.7% (Figure). Compared to carvedilol, bisoprolol had a lower one year MACE with adjusted HR 0.73 (0.58-0.93). There was no statistical difference in renal events and all-cause mortality or all-cause hospitalization.
Conclusion
The three GDMT beta blockers were associated with similar one year mortality and hospitalizations in patients with CKD and HFrEF. However, bisoprolol was associated with lower MACE outcomes.