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- Title
Beneficial Effect on Surrogate Markers of Heart Failure with Bisoprolol Up-Titration to Recommended Targets in Korean Patients with Heart Failure and Left Ventricular Systolic Dysfunction.
- Authors
Han, Seong Woo; Choi, Suk‐Won; Ryu, Kyu‐Hyung; Kim, Hyun‐Joong; Kim, Sung Hea; Shim, Wan Joo; Cha, Tae‐Joon; Choi, Dong‐Ju; Kim, Yong‐Jin; Yoo, Byung‐Su; Kim, Jun‐Hyung; Hwang, Kyung‐Kuk; Jeon, HuiKyung; Shin, Mi‐Seung
- Abstract
Introduction The objective of this study was to establish the benefit of bisoprolol up-titration toward recommended dosage targets, versus lower-dose maintenance, in heart failure ( HF) patients with systolic dysfunction. Methods Korean HF patients received bisoprolol 1.25 mg/day, incrementally up-titrated toward 10 mg/day in the absence of contraindications. After 26 weeks' treatment, patients were grouped as low-dose (<3.75 mg/day) or high-dose (≥3.75 mg/day). Primary endpoint was change in serum N-terminal probrain natriuretic peptide ( NT-pro BNP). Other markers of HF were also evaluated. Results 159 of 180 enrolled patients were evaluable. After 16 weeks' follow-up, there were 52 and 107 patients in the low- and high-dose groups respectively. Mean bisoprolol dosage was 5.4 mg/day; 24% of patients achieved target (10 mg/day). Mean log NT-pro BNP significantly decreased in both groups, with no significant difference in the magnitude of change between groups. Mean heart rate ( HR) and blood pressure decreased significantly in both groups, but only HR showed a significantly greater change in high-dose versus low-dose patients. In both groups, mean left ventricular ( LV) end-systolic and end-diastolic dimensions were significantly decreased and mean LV ejection fraction was significantly improved. Mean 6-min walk test distances improved in both groups (significant in low-dose patients only). Functional class improvement was observed in both low- and high-dose patients. No patients were rehospitalized due to aggravated HF. Conclusions In HF patients with systolic dysfunction, any bisoprolol dose is beneficial, but an attempt to up-titrate toward guideline-recommended dosages offers additional benefit in terms of restoration of LV systolic function and remodeling.
- Subjects
HEART failure treatment; BISOPROLOL; DRUG dosage; SYSTOLIC blood pressure; BLOOD pressure measurement; THERAPEUTICS
- Publication
Cardiovascular Therapeutics, 2016, Vol 34, Issue 3, p172
- ISSN
1755-5914
- Publication type
Article
- DOI
10.1111/1755-5922.12185