PD31-12 MIRABEGRON AND THE RISK OF ARRHYTHMIAS: A POPULATION-BASED COHORT STUDY
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Résumé
You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction I (PD31)1 Apr 2019PD31-12 MIRABEGRON AND THE RISK OF ARRHYTHMIAS: A POPULATION-BASED COHORT STUDY Rano Matta*, Simon Greaves, David Juurlink, Muhammad Mamdani, Tara Gomes, and Mina Tadrous Rano Matta*Rano Matta* More articles by this author , Simon GreavesSimon Greaves More articles by this author , David JuurlinkDavid Juurlink More articles by this author , Muhammad MamdaniMuhammad Mamdani More articles by this author , Tara GomesTara Gomes More articles by this author , and Mina TadrousMina Tadrous More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556179.72694.b2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Mirabegron, a β-3 adrenoreceptor agonist, used to treat overactive bladder (OAB) has been shown in clinical trials to produce a minor increase in resting heart rate, blood pressure, and QTc interval. More patients are being prescribed mirabegron, owing to its limited adverse effects relative to antimuscarinic OAB drugs. However, there is a lack of cardiovascular safety data in older patients and those with existing cardiovascular disease. We evaluated the risk of cardiac arrhythmias and other adverse cardiovascular events in older patients using mirabegron relative to other OAB agents. METHODS: We conducted a population-based cohort study of patients ≥66 years old who were new users of OAB drugs between June 1, 2015 and March 31, 2017 in Ontario, Canada. We followed patients for one year after starting the medication or until they discontinued or switched treatment. The primary outcome was a composite of hospitilization or emergency room visit for arrhythmia and tachycardia events. The secondary outcome was myocardial infarction (MI) or stroke. Patients taking mirabegron were matched to subjects taking other OAB agents on age, sex, date of initiating medication, and a high dimensional propensity score. The primary analysis used Cox proportional hazards regression. RESULTS: We matched 16,948 mirabegron users to 21,870 users of other OAB drugs. The median age of the cohort was 76 (Interquartile range 71-83), and most were female (N=25,189, 64.9%). A large proportion of the cohort had hypertension (N=30,393, 78.3%) and diabetes (N=13,757, 35.4%). Overall, 624 (1.6%) patients experienced an arrythmia or tachycardia event and 480 (1.2%) experienced an MI or stroke. The 1-year cumulative incidence of arrhythmia or tachycardia events was 3.3% in the mirabegron group and 3.5% in the other OAB drugs group (adjusted? Hazard Ratio [HR] 0.93; 95% Confidence Interval [CI] 0.80-1.09). Mirabegron was not associated with an increased risk of MI or stroke compared to other OAB drugs (HR 1.06; 95% CI 0.89-1.27). CONCLUSIONS: In a population-based cohort of older patients, use of mirabegron was not associated with an increased risk of arrhythmia or other cardiovascular events compared to other OAB drugs. These results are supportive of current prescribing trends and give a balanced view of real-world safety of this treatment option. Source of Funding: None. Toronto, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e570-e570 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rano Matta* More articles by this author Simon Greaves More articles by this author David Juurlink More articles by this author Muhammad Mamdani More articles by this author Tara Gomes More articles by this author Mina Tadrous More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».