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Nebivolol Less Effective in Elderly With CHF and Diabetes

Diabetes appears to reduce benefits of β blocker in heart failure patients aged 70 and older

FRIDAY, July 23 (HealthDay News) -- In patients aged 70 and older with heart failure, diabetes is associated with a worse prognosis, and nebivolol is less effective in patients with diabetes than in those without it, according to research published in the July 1 issue of the American Journal of Cardiology.

Rudolf A. de Boer, M.D., of the University of Groningen in the Netherlands, and colleagues analyzed data from 2,128 heart failure patients aged 70 and older in the Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors with heart failure study, which assessed the effect of the vasodilator β blocker nebivolol on mortality and cardiovascular hospitalization, which was the primary outcome. Roughly one quarter (26.1 percent) had diabetes.

The researchers found that, in patients without diabetes, the rate of the primary outcome for placebo versus nebivolol was significantly reduced: 33.7 percent in the placebo group and 27.8 percent for the nebivolol group (hazard ratio, 0.78). In patients with diabetes, however, such reductions were not observed and the researchers concluded that diabetes mellitus was associated with a worse prognosis in those 70 years of age and older with heart failure.

"Overall, nebivolol has shown a reduction in the risk of death or cardiovascular hospital admission in patients ≥70 years old with heart failure. However, the results from the present analysis suggest that diabetes mellitus attenuates the beneficial effects of nebivolol. The prognostic consequences of diabetes mellitus were more prominent in patients with a non-ischemic heart failure etiology," the authors write.

Several co-authors disclosed financial relationships with Menarini Ricerche SpA.

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