| Objective:This study intends to evaluate the prognosis of two different beta-blockers,metoprolol and bisoprolol,on chronic heart failure and provide a reference for the clinical pharmacological treatment of chronic heart failure.Methods:Propensity score matching was used in this study to equalize the confounding bias between the two groups and to reduce study-generated error.During the analysis,unbalanced covariates such as platelet level,age,serum creatinine phosphokinase level,anemia,hypertension,serum creatinine level,ejection fraction,and smoking in the blood of the two groups were placed in propensity score matching,and their propensity score values were measured on this basis using logistic regression analysis,and finally,the two groups with similar individuals were matched according to the propensity score values using the nearest neighbor matching method with the caliper value set at 0.05.The overall balance test was used to test the balance of the independent variables between the groups,and the standard difference after matching reflected the satisfaction of the matching results.Subsequently,survival analysis was performed for the two groups after matching to explore the prognosis of patients in both groups.Following this,survival analysis was performed on the unmatched population and the stability of the results was demonstrated by sensitivity analysis.Results:A total of 299 study subjects were included in this study.Before matching,baseline data showed statistically significant differences in patient age,platelet levels in blood,ejection fraction,anemia,serum creatinine phosphokinase levels,hypertension,serum creatinine levels,and smoking between the two groups(P<0.05).After propensity score matching,53 pairs of patients were successfully matched,and the differences between the two groups of patients after matching were not statistically significant for 11 covariates,including age,serum creatinine level,platelet level in blood,ejection fraction,anemia,hypertension,serum creatinine phosphokinase level,and smoking(P>0.05).The overall standardized mean difference of the study subjects before matching was 0.5778,and after matching the overall standardized mean difference was 0.0098,which improved the overall balance by 98.2%.The standardized mean differences of baseline parameters for both groups after matching were <0.1,demonstrating good balance of variables between groups.Survival analysis of the two groups after matching showed that the 100-day survival rate for patients taking metoprolol was 60.38% and the 200-day survival rate was32.08%;the 100-day survival rate for patients taking bisoprolol was 52.83% and the200-day survival rate was 16.98%,and there was no significant difference in the overall survival rate of patients with chronic heart failure between the two groups(P=0.43).Survival analysis of the unmatched population and KM plots showed no significant difference in overall survival between the two groups of patients with chronic heart failure(P=0.24),which proved stable results as a comparison,indicating that similar conclusions can be drawn even with loss of sample size,while ensuring a balance between the groups of variables and greater certainty of correct conclusions.Conclusion:(1)Balanced confounding using propensity scoring in non-randomized studies is more effective.(2)There is no significant difference in prognosis between the two groups of patients with chronic heart failure taking metoprolol and bisoprolol,so when conditions permit,patients with heart failure are recommended to take bisoprolol,which has fewer side effects,and this may provide a theoretical reference for clinical pharmacological treatment of chronic heart failure. |
PDF Full Text Request