Heart failure & cardiomyopathiesCohort study
Beta-blockers in Patients with Heart Failure with Reduced Ejection Fraction and Concomitant Chronic Obstructive Pulmonary Disease: Cardiovascular and Respiratory Outcomes
- Registry-based cohort study
- overlap-weighted
Falsification analyses suggested no influence from residual confounding.
Authors' conclusion
In patients with HFrEF and COPD, beta-blocker use was associated with lower risk of cardiovascular death/total HHF, without evidence of safety concerns for COPD exacerbations.
Study context
- Population
- Patients with HFrEF and Chronic Obstructive Pulmonary Disease (COPD), Swedish Heart Failure (HF) Registry, 2006–202391.5% used beta-blockers
- Participants
- 5,084 patients
- Exposure
- Beta-blocker use vs no beta-blocker use
- Outcome
- CV death/total HF hospitalizations (effectiveness); total severe COPD exacerbations (respiratory safety)
- Follow-up
- 5-year
Main finding
CV death/total HHF · median follow-up 2.5 years
Relative risk
0.74
95% CI 0.58–0.96
Beta-blocker users vs No beta-blocker
RR 0.74 (95% CI 0.58–0.96)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | RR (95% CI) | |
|---|---|---|
| CV death/total HHF, crude · crude | 0.66 (0.56–0.78) | |
| 0.512Relative risk (log scale) |
CV death/total hospitalizations for HF (HHF) by LVEF <30% (subgroup)
- Greater magnitude of association with lower risk in LVEF <30%; otherwise consistent across subgroups (including GOLD groups)
- p for interaction = 0.004
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| Total severe COPD exacerbations — Beta-blocker users vs No beta-blocker · after overlap weighting | 0.99 (0.73–1.35) | |
| Total severe COPD exacerbations — Beta-blocker users vs No beta-blocker · crude | 0.75 (0.60–0.93) | |
| 0.512Relative risk (log scale) |
Original publication
Beta-blockers in Patients with Heart Failure with Reduced Ejection Fraction and Concomitant Chronic Obstructive Pulmonary Disease: Cardiovascular and Respiratory Outcomes. Eur J Heart Fail. Published 11 September 2025. doi:10.1002/ejhf.70046
Summarised from the published abstract; every number is checked against it