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

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

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Title: Discharge β-Blocker Use and Race after Coronary Artery Bypass Grafting
Author: O’Neal, Wesley T.; Efird, Jimmy T.; Davies, Stephen W.; O’Neal, Jason B.; Griffin, William F.; Ferguson, T. Bruce; Chitwood, W. Randolph; Kypson, Alan P.

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Citation: O’Neal, Wesley T., Jimmy T. Efird, Stephen W. Davies, Jason B. O’Neal, William F. Griffin, T. Bruce Ferguson, W. Randolph Chitwood, and Alan P. Kypson. 2014. “Discharge β-Blocker Use and Race after Coronary Artery Bypass Grafting.” Frontiers in Public Health 2 (1): 94. doi:10.3389/fpubh.2014.00094. http://dx.doi.org/10.3389/fpubh.2014.00094.
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Abstract: 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 on patients undergoing CABG between 2002 and 2011. Long-term survival was compared in patients who were 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). Conclusion: 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.
Published Version: doi:10.3389/fpubh.2014.00094
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4114325/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:12785945
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