Evidence map›Paper›PMID 25037562›Full record

ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2014

Kidney function and population-based outcomes of initiating oral atenolol versus metoprolol tartrate in older adults.

Jamie L Fleet, Matthew A Weir, Eric McArthur, Sundus Ozair, Philip J Devereaux, Matthew A Roberts, Arsh K Jain, Amit X Garg

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 15 citations in OpenAlex.

  1. Article
  2. Article
  3. Clinical Outcomes of Failing to Dose-Reduce Cephalosporin Antibiotics in Older Adults with CKD.Clinical journal of the American Society of Nephrology : CJASN · 2019
    Article
  4. A conceptual framework for evaluating data suitability for observational studies.Journal of the American Medical Informatics Association : JAMIA · 2018
    Article
  5. Article
  6. Article
  7. Kidney function and the use of nitrofurantoin to treat urinary tract infections in older women.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2015
    Article
  8. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Jamie L FleetDivision of Nephrology, Department of Medicine, Western University, London, Canada; Institute for Clinical Evaluative Sciences, Ontario, Canada.
Matthew A WeirDivision of Nephrology, Department of Medicine, Western University, London, Canada.
Eric McArthurInstitute for Clinical Evaluative Sciences, Ontario, Canada.
Sundus OzairSchulich School of Medicine and Dentistry, Western University, London, Canada.
Philip J DevereauxDivision of Cardiology, Department of Medicine, McMaster University, Hamilton, Canada.
Matthew A RobertsDepartment of Nephrology, Austin Health, Melbourne, Australia.
Arsh K JainDivision of Nephrology, Department of Medicine, Western University, London, Canada; Institute for Clinical Evaluative Sciences, Ontario, Canada.
Amit X GargDivision of Nephrology, Department of Medicine, Western University, London, Canada; Institute for Clinical Evaluative Sciences, Ontario, Canada; Department of Epidemiology & Biostatistics, Western University, London, Canada. Electronic address: amit.garg@lhsc.on.ca.
Institute for Clinical Evaluative Sciences · CAWestern University · CAAustin Health · AUMcMaster University · CA

Funding

Canadian Institutes of Health Research
6 · The paper itself

Abstract

backgroundAtenolol and metoprolol tartrate are commonly prescribed β-blockers. Atenolol elimination depends on kidney function, whereas metoprolol tartrate does not. We hypothesized that compared to metoprolol tartrate, initiating oral atenolol treatment would be associated with more adverse events in older adults, with the association most pronounced in patients with lower baseline estimated glomerular filtration rates (eGFRs). STUDY

designPopulation-based matched retrospective cohort study. SETTING &

participantsOlder adults (mean age, 75 years) in Ontario, Canada, prescribed oral atenolol versus metoprolol tartrate from April 2002 through December 2011. The 2 groups were well matched (n=75,257 in each group), with no difference in 31 measured baseline characteristics. Patients with end-stage renal disease were ineligible, and 4.6% of patients had chronic kidney disease (median eGFR, 38mL/min/1.73m(2) assessed through a database algorithm). PREDICTORS: β-Blocker type and eGFR. OUTCOMES: A composite outcome of hospitalization with bradycardia or hypotension and all-cause mortality were assessed in 90-day follow-up.

resultsCompared to metoprolol tartrate, initiating atenolol treatment was not associated with higher risk of hospitalization with bradycardia or hypotension (incidence, 0.71% vs 0.79%; relative risk, 0.90; 95%CI, 0.80-1.01). Atenolol treatment initiation was associated with lower 90-day risk of mortality than metoprolol tartrate (incidence, 0.97% vs 1.44%; relative risk, 0.68; 95%CI, 0.61-0.74). Lower eGFR did not modify either association (P for interaction=0.5 and 0.6, respectively). LIMITATIONS: Heart rate and blood pressure were not available in our data sources, and effects ascertained from observational studies are subject to residual confounding.

conclusionsContrary to our expectation, we found that atenolol versus metoprolol tartrate was associated with lower 90-day risk of mortality in patients regardless of eGFR, with no difference in risk of hospitalization with bradycardia or hypotension.

Indexed as

Administration, OralAdrenergic beta-1 Receptor AntagonistsAgedAged, 80 and overAtenololCohort StudiesFemaleFollow-Up StudiesHumansKidneyMaleMetoprololPopulation SurveillanceRenal Insufficiency, ChronicRetrospective StudiesTreatment OutcomeAdrenergic beta-1 Receptor AntagonistsAtenololMetoprololadverse eventsAtenololbeta-blockerbradycardiachronic kidney disease (CKD)drug safetyelderlyhypotensionmetoprolol tartrateolder adultsrenal function

Identifiers

PMID25037562
OpenAlexW2005139038

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.