Beta Blockers Increase Post-MI Survival in COPD

The use of β-blockers in patients with chronic obstructive pulmonary disorder (COPD) with myocardial infarction is associated with improved survival, according to a new study.

Despite the standard practice of β-blocker use in patients undergoing noncardiac surgery, they are often withheld from patients with COPD and coexisting cardiovascular disease due to risk of bronchoconstriction. In order to determine whether β-blockers are associated with greater survival in COPD patients with myocardial infarctions, English researchers followed 1063 patients using data from the Myocardial Ischaemia National Audit Project.

Participants all had COPD and a first MI between 2003 and 2008. Treatment with β-blockers during initial hospitalization for MI was associated with significant survival benefits (hazard ratio 0.50, 95% confidence interval 0.36 to 0.69; P<0.001; median follow-up time 2.9 years).

Patients already taking β-blockers before MI also benefited (0.59, 0.44 to 0.79; P<0.001). “Our data suggest that β blockers should be used more widely in patients with COPD who have had a myocardial infarction,” researchers concluded.

“Safety to date is good in these patients, but further evaluation of the safety of β blockers in this high risk group might be required to change current prescribing practice.”

–Michael Potts

Reference

Quint JK, Herrett E, Bhaskaran K, Timmis A, et al. Effect of β blockers on mortality after myocardial infarction in adults with COPD: population based cohort study of UK electronic healthcare records. BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f6650