1 research outputs found
Effects of beta-blocker therapy on hs-CRP levels in elderly patients with ischemic and non-ischemic heart failure: Results from the CIBIS-ELD trail
C reactive protein (CRP) is a biomarker indicating systemic inflammation. Elevated levels of this biomarker are associated with increased rates of cardiovascular disease, including chronic heart failure (HF). Highâsensitivity CRP assays were developed in order to measure lower levels of CRP, down to 0.3mg/l (hsâCRP). Up to now, very little is known about the effects of betaâblocker titration on hsâCRP levels in ischemic and nonâischemic HF patients. Also, little is known if this effect differs between selective and unselective blockers. Purpose: This research explored the trajectories of hsâCRP before and after betaâblocker (carvedilol vs bisoprolol) titration in elderly HF patients depending on the type of betaâblocker used and the etiology of the disease (ischemic vs nonâischemic). Methods: We measured plasma levels of hsâCRP and NTâproBNP in 520 HF patients â„ 65 years (72.06±5.24 years, 38%f, LVEF 41.8±13.8%; ischemic n=243; nonischemic n=277) of the Cardiac Insufficiency Bisoprolol Study in ELDerly (CIBISâELD). In this trial, patients were randomized to bisoprolol vs. carvedilol and doses were uptitrated to the target or maximally tolerated dose. hsâCRP and NTâproBNP levels were assessed at baseline (BL) and at followâup (FU), after 12 weeks. Results: In patients with ischemic HF, hsâCRP levels decreased in the bisoprolol group (BL=0.60±0.94 mg/ dl, n=166; FU=0.43±0.694mg/dl, n=131; p=0.010), and were without a change in the carvedilol group (BL=0.60±1.69mg/dl, n=181; FU=0.57±0.982mg/ dl, n=136; p=0.731). There was also no change of hsâCRP levels in nonâischemic HF patients in both groups (bisoprolol: BL=0.64±1.175 mg/dl, n=197; FU=0.470±0.81mg/dl, n=152, p=0.069; carvedilol: BL=0.45±0.78mg/dl, n=198; FU=0.41±0.701 mg/ dl, n=152, p=0.420). Plasma levels of NTâproBNP decreased in ischemic patients treated with bisoprolol, (BL=1594±2146 pg/ml, n=169; FU=1468±2110pg/ ml, n=133, p=0.04), while changes in the carvedilol group were not significant (BL=1648±1991 pg/ml, n=188; FU=1567±2119pg/ml, n=135, p=0.556). In the nonâischemic group NTâpro levels did not change significantly in the carvedilol group, while there was an increase in nonâischemic patients in the bisoprolol group (BL=1427±3113 pg/ml, n=208; FU=1533±5385 pg/ml, n=166, p=0.017). Conclusion: Results indicate that bisoprolol might be associated with a decrease of hsâCRP and NTâproBNP levels only in ischemic HF patients, while in nonischemic HF patients there was no change of hsâCRP and an increase of NTâproBNP levels. In carvedilol treated patients no significant changes were shown in neither group