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Beta blocker versus ivabradine for cardiovascular outcomes among patients with atrial fibrillation
  1. Wei Syun Hu1,2,
  2. Cheng Li Lin1
  1. 1School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
  2. 2Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
  1. Correspondence to Dr Wei Syun Hu, Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital 2, Yuh-Der Road, Taichung 40447, Taiwan; WEISYUNHU{at}GMAIL.COM

Abstract

Purpose We conducted a retrospective observational study using Taiwanese insurance records to examine the association between beta blocker (BB)/ ivabradine (IVA) and cardiovascular (CV) outcomes in patients with atrial fibrillation (AF).

Methods A total of 1884 AF subjects were enrolled. The propensity score-matching technique was applied to estimate the effect of IVA by accounting for the covariates. The CV outcomes included hospitalisation/rehospitalisation due to acute myocardial infarction, heart failure (HF), haemorrhagic stroke, ischaemic stroke, CV death and all-cause death. Univariate and multivariate Cox proportional hazards regression models were used to estimate crude and adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).

Results IVA users were found to have a higher risk of HF requiring admission (adjusted HR=2.01; 95% CI 1.67 to 2.42), and all cause death (adjusted HR=1.47; 95% CI 1.11 to 1.94) after adjusting for age, sex, comorbidities and medications.

Conclusion Concerning adverse clinical events, IVA might not be appropriate for patients with AF.

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Correction notice Since this article first published, the result section of the abstract has been updated to read 'IVA users were found to have a higher risk of HF…'.

  • Contributors WSH and CLL contributed to the manuscript. All were involved in the design of the study, collected the data, statistical analysis, wrote the manuscript and all authors were involved in the final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.