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Effects of Beta-Blockers on Cardiovascular Events and Mortality in Dialysis Patients: A Systematic Review and Meta-Analysis

机译：β阻断剂对透析患者心血管事件和死亡率的影响：系统审查和荟萃分析

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Background: The effects of beta-blockers are uncertain in dialysis patients. Except antihypertension, beta-blockers may play a unique cardiovascular protective role in the population. This meta-analysis aimed to explore the effects of beta-blockers therapy in adult patients treated with dialysis. Methods: We searched MEDLINE, EMBASE, and the Cochrane library from inception to May 2018 for randomized controlled trials (RCTs) and observational studies about the role of beta-blockers on all-cause mortality, cardiovascular mortality, cardiovascular events, or hospitalizations in dialysis population. Results: Three RCTs and 9 observational studies met the predefined inclusion criteria. The RCTs showed significant association between beta-blockers and reduced all-cause mortality (n = 363; risk ratio [RR] 0.73; 95% CI 0.54-0.97), cardiovascular mortality (n = 314; RR 0.44; 95% CI 0.29-0.68), cardiovascular events (n = 363; RR 0.52; 95% CI 0.31-0.88), or hospitalizations (n = 314; RR 0.61; 95% CI 0.48-0.78) in dialysis patients. The observational studies showed significant difference in all-cause mortality (n = 35,233; hazard ratio [HR] 0.86; 95% CI 0.80-0.92) between beta-blockers and no beta-blockers therapy in patients with dialysis, while the studies showed no difference in cardiovascular mortality (n = 19,413; HR 0.79; 95% CI 0.57-1.11), or cardiovascular events (n = 87,060; HR 0.79; 95% CI 0.50-1.26). Conclusions: beta-blockers seem to be associated with reduced mortality in patients on dialysis. Both the statistical heterogeneity in observational studies and the small number of participants and studies in RCTs limit the strength of these findings. (C) 2019 S. Karger AG, Basel
机译：背景：β-阻滞剂的效果在透析患者中​​不确定。除抗高血压外，β受体阻滞剂可能在人口中起着独特的心血管保护作用。该荟萃分析旨在探讨β-ocketers治疗在透析治疗的成年患者中的影响。方法：我们搜索了Medline，Embase和Cochrane图书馆，从2008年5月开始，用于随机对照试验（RCT）和关于β-obleters对透析中的所有原因死亡率，心血管死亡率，心血管事件或住院的作用的观察研究人口。结果：三个RCT和9项观测研究符合预定义的纳入标准。 RCT显示β-阻滞剂之间的显着关联，并降低了所有原因死亡率（n = 363;风险比[RR] 0.73; 95％CI 0.54-0.97），心血管死亡率（n = 314; RR 0.44; 95％CI 0.29- 0.68），心血管事件（n = 363; rr 0.52; 95％ci 0.31-0.88），或住院（n = 314; rr 0.61; 95％ci 0.48-0.78）在透析患者中​​。观察性研究显示出β-障碍物与透析患者患者之间的所有原因死亡率（n = 35,233;危害比[HR] 0.86; 95％CI 0.80-0.92）。在透析患者中​​，患者没有心血管死亡率的差异（n = 19,413; HR 0.79; 95％CI 0.57-1.11），或心血管事件（n = 87,060; HR 0.79; 95％CI 0.50-1.26）。结论：β-嵌体似乎与透析患者的死亡率降低有关。观察研究中的统计异质性以及RCT的少数参与者和研究中的研究限制了这些发现的强度。 （c）2019年S. Karger AG，巴塞尔

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