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dc.date.accessioned2021-04-29T19:11:56Z
dc.date.available2021-04-29T19:11:56Z
dc.date.created2021-03-13T12:17:02Z
dc.date.issued2021
dc.identifier.citationDhar, Indu Svingen, Gard Frodahl Tveitevåg Olsen, Thomas Lysne, Vegard Bjørnestad, Espen Øglænd Ueland, Per Magne Nygård, Ottar Kjell . β-blocker use and risk of all-cause mortality in patients with coronary heart disease: effect modification by serum vitamin A. European Journal of Preventive Cardiology (EJPC). 2021
dc.identifier.urihttp://hdl.handle.net/10852/85723
dc.description.abstractAbstract Aims  Blockade of β-adrenoceptors reduces sympathetic nervous system activity and improves survival in patients with heart failure with reduced left ventricular ejection fraction (HFrEF); however, any improvement in longevity among patients with coronary heart disease (CHD) but without HFrEF remains uncertain. Vitamin A has been linked to the activation of tyrosine hydroxylase, the rate-limiting enzyme in the catecholamine synthesis pathway. We investigated if vitamin A status modified the association of β-blocker use with the risk of all-cause mortality. Methods and results  A total of 4118 patients undergoing elective coronary angiography for suspected stable angina pectoris, of whom the majority had normal left ventricular ejection fraction (LVEF) were studied. Hazard ratios (HRs) of all-cause mortality comparing treatment vs. non-treatment of β-blockers according to the tertiles of serum vitamin A were explored in Cox proportional hazards regression models. During a median follow-up of 10.3 years, 897 patients (21.8%) died. The overall LVEF was 65% and 283 (6.9%) had anamnestic HF. After multivariable adjustments for traditional risk factors, medical history, and drug therapies of cardiovascular disease, β-blocker treatment was inversely associated with the risk of all-cause mortality [HR : 0.84; 95% CI (confidence interval), 0.72–0.97]. However, the inverse association was generally stronger among patients in the upper serum vitamin A tertile (HR :0.66; 95% CI, 0.50–0.86; Pinteraction = 0.012), which remained present after excluding patients with LVEF < 40%. Conclusion  In patients with suspected CHD, β-blocker treatment was associated with improved survival primarily among patients with high serum vitamin A levels.
dc.languageEN
dc.rightsAttribution-NonCommercial 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.titleβ-blocker use and risk of all-cause mortality in patients with coronary heart disease: effect modification by serum vitamin A
dc.typeJournal article
dc.creator.authorDhar, Indu
dc.creator.authorSvingen, Gard Frodahl Tveitevåg
dc.creator.authorOlsen, Thomas
dc.creator.authorLysne, Vegard
dc.creator.authorBjørnestad, Espen Øglænd
dc.creator.authorUeland, Per Magne
dc.creator.authorNygård, Ottar Kjell
cristin.unitcode185,51,13,20
cristin.unitnameSeksjon for klinisk ernæring
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode2
dc.identifier.cristin1897829
dc.identifier.bibliographiccitationinfo:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=European Journal of Preventive Cardiology (EJPC)&rft.volume=&rft.spage=&rft.date=2021
dc.identifier.jtitleEuropean Journal of Preventive Cardiology (EJPC)
dc.identifier.doihttps://doi.org/10.1093/eurjpc/zwaa158
dc.identifier.urnURN:NBN:no-88408
dc.type.documentTidsskriftartikkel
dc.type.peerreviewedPeer reviewed
dc.source.issn2047-4873
dc.identifier.fulltextFulltext https://www.duo.uio.no/bitstream/handle/10852/85723/1/zwaa158.pdf
dc.type.versionPublishedVersion


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