Journal of Shandong University (Health Sciences) ›› 2025, Vol. 63 ›› Issue (9): 1-10.doi: 10.6040/j.issn.1671-7554.0.2024.1469

• Special Issue on “Big DataEnabled, AI Foundation ModelDriven Multimodal Cohort Design and Analysis” •    

Therapeutic effect of nifedipine and metoprolol on heart disease

LYU Mingyue1,2,3, SUN Hanchen4, LUO Qingxin1,2,3, XU Zhaoke2,5, XU Ruize1,2,3, ZHANG Shuo1,2,3, YAN Luning1,2,3, HU Xifeng1,2, ZHAO Qingbo1,2, ZHU Gaopei1,2,3, XUE Fuzhong1,2,3   

  1. 1. Department of Medical Dataology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. National Institute of Health and Medical Big Data, Jinan 250003, Shandong, China;
    3. Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    4. National Administration of Health Data, Jinan 250002, Shandong, China;
    5. School of Information Science and Engineering, Shandong Normal University, Jinan 250399, Shandong, China
  • Published:2025-09-08

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Abstract: Objective To investigate the effects of nifedipine and metoprolol on major cardiovascular events, all-cause mortality, and drug-induced liver injury in patients with heart disease using real-world data. Methods Based on Cheeloo Lifespan Electronic Health Research Data-library(Cheeloo LEAD), a real-world study was conducted through a new user cohort design matched by a propensity score, including patients who were first diagnosed with heart disease between January 1, 2012 and December 31, 2022. A large-scale L1 regularized propensity score was used to match covariates and achieve quasi-randomization. The Cox proportional hazards regression model was then employed to assess the average causal effects of nifedipine(exposure group)and metoprolol(control group)on major cardiovascular events, all-cause mortality, and drug-induced liver injury, respectively. Results Men with heart disease were more likely to have major cardiovascular events, all-cause mortality, and drug-induced liver injury. Following the implementation of L1 regularized propensity score matching, the standardized differences of covariates were found to be less than 0.2, with the majority falling below 0.1, and the Kaplan-Meier survival curve revealed no discernible crossover between the exposed group and the control group. The log-rank tests for both drug-induced liver injury and all-cause mortality revealed statistically significant differences between groups(both P<0.05). Furthermore, the cumulative survival rate of patients who received nifedipine during the follow-up period was higher than that of patients who received metoprolol. The Cox proportional hazard regression model showed that nifedipine had a lower risk of drug-induced liver injury(HR=0.39, 95%CI: 0.16-0.93, P=0.025)and all-cause mortality(HR=0.53, 95%CI: 0.28-0.98, P=0.034)than metoprolol, no significant difference was observed between nifedipine and metoprolol in the prevention of major cardiovascular events(HR=1.30, 95%CI: 0.97-1.90, P=0.061). Conclusion Nifedipine may reduce the risk of all-cause mortality in patients with heart disease compared to metoprolol and is associated with a lower risk of drug-induced liver injury. These results provide supplementary evidence to support the safe usage of medications in patients with heart disease, particularly a reference for assessing the risk of pharmacogenetic liver injury.

Key words: Nifedipine, Metoprolol, Major adverse cardiovascular events, Drug-induced liver injury, Real-world research, Propensity score, Average causal effect

CLC Number: 

  • R453
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