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Bisoprolol trumps carvedilol in easing inflammation in chronic heart failure patients

17 Dec 2019

Bisoprolol may be more effective than carvedilol in reducing inflammation in patients with chronic heart failure (CHF), according to a subanalysis of the BRIGHT-D* study. However, carvedilol appears to have the upper hand in reducing oxidative stress.

BRIGHT-D enrolled 87 CHF patients, of whom 48 were eligible for the present subanalysis. These patients had baseline and follow-up information regarding oxidative stress, measured through the derivatives of reactive oxygen metabolites (d-ROMs). High-sensitivity C-reactive protein (hs-CRP) was used as a marker of inflammation.

Of the participants, 26 (mean age, 58.0±14.2 years; 76.9 percent male) were taking bisoprolol while the remaining 22 (mean age, 58.7±15.0 years; 77.3 percent male) were on carvedilol medication. Baseline levels of hs-CRP were comparable between groups (3.35±0.78 vs 3.38±0.59 log (ng/mL); p=0.064).

Concentrations of hs-CRP decreased over time in both treatment arms, though the 24-week change was greater in the bisoprolol group (to 2.69±0.44 log [ng/mL]; p=0.001) than in the carvedilol group (to 2.85±0.76 log [ng/mL]; p=0.047). Nevertheless, the change value in both groups were significant.

Overall levels of d-ROMs likewise decreased in both treatment arms over time. However, as opposed to hs-CRP trends, carvedilol produced a larger drop than bisoprolol at 24 weeks (382±84 to 312±76 U.CARR; p=0.006 vs 401±106 to 344±82 U.CARR; p=0.015). Baseline concentrations were statistically similar between the treatment arms.

*Bisoprolol Improvement Group for Chronic Heart Failure Treatment Study in Dokkyo Medical University

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