Impact of beta2-agonists, beta-blockers, and their combination on cardiac function in elderly male patients with chronic obstructive pulmonary disease

Purpose: This study was undertaken to determine the association between cardiac function and therapy with beta2-adrenoceptor agonists (beta(2)-agonists), beta-blockers, or beta-blocker-beta(2)-agonist combination therapy in elderly male patients with chronic obstructive pulmonary disease (COPD). Patients and methods: This was a retrospective cohort study of 220 elderly male COPD patients (mean age 84.1 +/- 6.9 years). The patients were divided into four groups on the basis of the use of beta-blockers and beta 2-agonists. N-terminal fragment pro-B-type natriuretic peptide (NT pro-BNP), left ventricular ejection fraction (LVEF), and other relevant parameters were measured and recorded. At follow-up, the primary end point was all-cause mortality. Results: Multiple linear regression analysis revealed no significant associations between NT pro-BNP and the use of beta 2-agonists (beta = 35.502, P = 0.905), beta-blockers (beta = 3.533, P = 0.989), or combination therapy (beta = 298.635, P = 0.325). LVEF was not significantly associated with the use of beta 2-agonists (beta = -0.360, P = 0.475), beta-blockers (beta = -0.411, P = 0.284), or combination therapy (beta = -0.397, P = 0.435). Over the follow-up period, 52 patients died, but there was no significant difference in mortality among the four groups (P = 0.357). Kaplan-Meier analysis showed no significant difference among the study groups (log-rank test, P = 0.362). After further multivariate adjustment, use of beta 2-agonists (hazard ratio [HR] 0.711, 95% confidence interval [CI] 0.287-1.759; P = 0.460), beta-blockers (HR 0.962, 95% CI 0.405-2.285; P = 0.930), or combination therapy (HR 0.638, 95% CI 0.241-1.689; P < 0.366) were likewise not correlated with mortality. Conclusion: There was no association between the use of beta 2-agonists, beta-blockers, or beta-blocker-beta 2-agonist combination therapy with cardiac function and all-cause mortality in elderly male COPD patients, which indicated that they may be used safely in this population.