Outcomes of “diabetes‐friendly” vs “diabetes‐unfriendly” β‐blockers in older nursing home residents with diabetes after acute myocardial infarction

• Published in: Diabetes, obesity & metabolism obesity & metabolism, 2018-12, Vol.20 (12), p.2724-2732
• Main Authors: Zullo, Andrew R., Hersey, Michelle, Lee, Yoojin, Sharmin, Sadia, Bosco, Elliott, Daiello, Lori A., Shah, Nishant R., Mor, Vincent, Boscardin, W. John, Berard‐Collins, Christine M., Dore, David D., Steinman, Michael A.
• Format: Article
• Language: English
• Subjects: ageing; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Heart attacks; Hospitalization; Hyperglycemia; Hypoglycemia; Myocardial infarction; nursing home; Nursing homes; Regression analysis; Vasodilation; β‐blockers
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/dom.13451

Aims To assess whether nursing home (NH) residents with type 2 diabetes mellitus (T2D) preferentially received “T2D‐friendly” (vs “T2D‐unfriendly”) β‐blockers after acute myocardial infarction (AMI), and to evaluate the comparative effects of the two groups of β‐blockers. Materials and Methods This new‐user retrospective cohort study of NH residents with AMI from May 2007 to March 2010 used national data from the Minimum Data Set and Medicare system. T2D‐friendly β‐blockers were those hypothesized to increase peripheral glucose uptake through vasodilation: carvedilol, nebivolol and labetalol. Primary outcomes were hospitalizations for hypoglycaemia and hyperglycaemia in the 90 days after AMI. Secondary outcomes were functional decline, death, all‐cause re‐hospitalization and fracture hospitalization. We compared outcomes using binomial and multinomial logistic regression models after propensity score matching. Results Of 2855 NH residents with T2D, 29% initiated a T2D‐friendly β‐blocker vs 24% of 6098 without T2D (P