Avtor/Urednik | Lainščak, Mitja; Podbregar, Matej; Kovačič, Dragan; Rozman, Janez; von Haehling, Stephan | |
Naslov | Differences between bisoprolol and carvedilol in patients with chronic heart failure and chronic obstructive pulmonary disease: a randomized trial | |
Tip | članek | |
Vir | Respir Med | |
Vol. in št. | Letnik 105, št. Suppl 1 | |
Leto izdaje | 2011 | |
Obseg | str. S44-9 | |
Jezik | eng | |
Abstrakt | Background: Chronic obstructive pulmonary disease (COPD) frequently coexists in patients with chronic heart failure (CHF) and is a key factor for beta blocker underprescription and underdosing. This study compared effects of bisoprolol and carvedilol in patients with both conditions. Methods: This was a randomized open-label study, of bisoprolol and carvedilol during initiation and uptitration to target or maximal tolerated dose. Pulmonary function testing, 12-lead electrocardiogram, and N-terminal pro brain natriuretic peptide were measured at baseline and follow-up. Results: We randomized 63 elderly patients (73 +/- 9 years, 81% men, left ventricular ejection fraction 33 +/- 7%) with mild to moderate CHF (54% New York Heart Assocation class II) and moderate to severe COPD (76% Global initiative for chronic Obstructive Lung Disease stage 2). Target dose was tolerated by 31 (49%) patients and 19 (30%) patients experienced adverse events during follow-up (19% bisoprolol, 42% carvedilol, p = 0.045). Study medication had to be withdrawn in 8 (13%) patients (bisoprolol: 2 due to hypotension, 1 due to bradycardia; carvedilol: 2 due to hypotension and 1 due to wheezing, dyspnoea, and oedema, respectively). Forced expiratory volume in 1(st) second significantly increased in bisoprolol (1561 +/- 414 ml to 1698 +/- 519 ml, p = 0.046) but not carvedilol (1704 +/- 484 to 1734 +/- 548, p = 0.44) group. Both agents reduced heart rate (bisoprolol: 75 +/- 14 to 68 +/- 10, p = 0.007; carvedilol 78 +/- 14 to 72 +/- 12, p = 0.016) and had no effect on N-terminal pro brain natriuretic peptide. Conclusions: Beta blockers frequently caused adverse events, and thus 49% of patients could tolerate the target dose. Bisoprolol induced demonstrable improvement in pulmonary function and caused less adverse events. | |
Deskriptorji | HEART FAILURE, CONGESTIVE LUNG DISEASES, OBSTRUCTIVE COMORBIDITY BISOPROLOL STROKE VOLUME AGED ELECTROCARDIOGRAPHY NATRIURETIC HORMONE ADRENERGIC BETA-ANTAGONISTS RANDOMIZED CONTROLLED TRIALS TREATMENT OUTCOME |