PD31-12 MIRABEGRON AND THE RISK OF ARRHYTHMIAS: A POPULATION-BASED COHORT STUDY
Bibliographic record
Abstract
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 ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".