Imperial College London
Alternate

ProfessorWisiaWedzicha

Faculty of Medicine, National Heart & Lung Institute

Consul (clinical) for the Faculty of Medicine
 
 
 
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Contact

 

j.wedzicha

 
 
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Location

 

B142Guy Scadding BuildingRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Quint:2013:10.1136/bmj.f6650,
author = {Quint, JK and Herrett, E and Bhaskaran, K and Timmis, A and Hemingway, H and Wedzicha, JA and Smeeth, L},
doi = {10.1136/bmj.f6650},
journal = {British Medical Journal},
title = {Effect of β blockers on mortality after myocardial infarction in adults with COPD: Population based cohort study of UK electronic healthcare records},
url = {http://dx.doi.org/10.1136/bmj.f6650},
volume = {347},
year = {2013}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objectives: To investigate whether the use and timing of prescription of β blockers in patients with chronic obstructive pulmonary disease (COPD) having a first myocardial infarction was associated with survival and to identify factors related to their use. Design: Population based cohort study in England. Setting: UK national registry of myocardial infarction (Myocardial Ischaemia National Audit Project (MINAP)) linked to the General Practice Research Database (GPRD), 2003-11. Participants: Patients with COPD with a first myocardial infarction in 1 January 2003 to 31 December 2008 as recorded in MINAP, who had no previous evidence of myocardial infarction in their GPRD or MINAP record. Data were provided by the Cardiovascular Disease Research using Linked Bespoke studies and Electronic Health Records (CALIBER) group at University College London. Main outcome measure: Cox proportional hazards ratio for mortality after myocardial infarction in patients with COPD in those prescribed β blockers or not, corrected for covariates including age, sex, smoking status, drugs, comorbidities, type of myocardial infarction, and severity of infarct. Results: Among 1063 patients with COPD, treatment with β blockers started during the hospital admission for myocardial infarction was associated with substantial survival benefits (fully adjusted hazard ratio 0.50, 95% confidence interval 0.36 to 0.69; P<0.001; median follow-up time 2.9 years). Patients already taking a β blocker before their myocardial infarction also had a survival benefit (0.59, 0.44 to 0.79; P<0.001). Similar results were obtained with propensity scores as an alternative method to adjust for differences between those prescribed and not prescribed β blockers. With follow-up started from date of discharge from hospital, the effect size was slightly attenuated but there was a similar protective effect of treatment with β blockers started during hospital admission for myocardial inf
AU  - Quint,JK
AU  - Herrett,E
AU  - Bhaskaran,K
AU  - Timmis,A
AU  - Hemingway,H
AU  - Wedzicha,JA
AU  - Smeeth,L
DO  - 10.1136/bmj.f6650
PY  - 2013///
SN  - 1468-5833
TI  - Effect of β blockers on mortality after myocardial infarction in adults with COPD: Population based cohort study of UK electronic healthcare records
T2  - British Medical Journal
UR  - http://dx.doi.org/10.1136/bmj.f6650
UR  - http://hdl.handle.net/10044/1/23972
VL  - 347
ER  -
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