Metoprolol versus Carvedilol in Patients with Heart Failure, Chronic Obstructive Pulmonary Disease, Diabetes Mellitus, and Renal Failure

ABSTRACT This study aims to compare the survival and the risk of heart failure, chronic obstructive pulmonary disease, diabetes mellitus, hypoglycemia, and renal failure hospitalizations in geriatric patients that were exposed to carvedilol or metoprolol. Danish administrative healthcare registers were used as data sources. Patients aged ≥ 65 and having heart failure, chronic obstructive pulmonary disease, and diabetes mellitus were followed for 1 year from the date of the first beta-blocker prescription redemption. Baseline characteristics of patients were used to 1:1 propensity score match carvedilol and metoprolol users. A Cox regression model was used to compute the hazard ratio (HR) of study outcomes. For statistically significant associations, a conditional inference tree was used to recursively partition the predictors most associated with the outcome. In total, 1424 patients were included. No statistically significant differences were observed for survival (HR 0.86; 95% Confidence Interval, 95%CI 0.67-1.11, p=0.240) between carvedilol and metoprolol users. The same applied to chronic obstructive pulmonary disease (HR 0.88; 95%CI 0.75-1.05, p=0.177), diabetes mellitus (HR 0.95; 95%CI 0.82-1.10, p=0.485), hypoglycaemia (HR 0.88; 95%CI 0.47-1.67, p=0.707) and renal failure (HR 1.25; 95%CI 0.93-1.69, p=0.142) hospitalizations. Carvedilol users had a 38% higher hazard then metoprolol users of heart failure hospitalization during the follow-up period (HR 1.38; 95%CI 1.19-1.60, p