Discharge β-blocker Use and Race after Coronary Artery Bypass Grafting

• Main Authors: Wesley T. O'Neal (Author), Jimmy Thomas Efird (Author), Stephen Wayne Davies (Author), Jason Benjamin O'Neal (Author), William F. Griffin (Author), T. Bruce Ferguson (Author), W. Randolph Chitwood (Author), Alan eKypson (Author)
• Format: Book
• Published: Frontiers Media S.A., 2014-07-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Introduction: The use of discharge β-blockers after cardiac surgery is associated with a long-term mortality benefit. β-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 of patients undergoing CABG between 2002 and 2011. Long-term survival was compared in patients who 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 β-blocker use was computed using a likelihood ratio test.Results: A total of 853 (88%) black (n=970) and 3,038 (88%) white (n=3,460) patients had a history of β-blocker use at discharge (N=4,430). 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 HR=0.33, 95%CI=0.23-0.46; white: adjusted HR=0.48, 95%CI=0.39-0.58; p-for-interaction=0.74). Among patients discharged on β-blockers, we did not observe a long-term survival advantage for white compared with black patients (HR=1.2, 95%CI=0.95-1.5). Conclusions: β-blocker use at discharge was associated with a survival advantage among black patients after CABG and a similar association was observed in white patients.

Item Description

2296-2565
10.3389/fpubh.2014.00094