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Olle Melander

Principal investigator

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Serum biomarkers and clinical outcomes in heart failure patients treated de novo with carvedilol

Author

  • Jadwiga Nessler
  • Bohdan Nessler
  • Renata Golebiowska-Wiatrak
  • Ilona Palka
  • Andrzej Gackowski
  • Mariusz Kitlinski
  • Olle Melander
  • Artur Fedorowski

Summary, in English

Background: The role of inflammatory and hemodynamic stress biomarkers in heart failure (HF) patients treated de novo with beta-blockers has been poorly studied. Methods: A total of 86 patients (age 56 +/- 9 years, 81 men) with left ventricular ejection fraction (LVEF) < 40% and previously not treated with beta-blockers were initiated on carvedilol. At baseline and 12 months later we performed echocardiography, cardiopulmonary exercise testing, and determined serum levels of B-type natriuretic peptide (BNP), endothelin-1 (ET-1), C-reactive protein (CRP), interleukin-6, and tumor necrosis factor alpha (TNF-alpha). Patients were followed up over a total period of 9 +/- 3 years from baseline. Results: Increased baseline CRP and its on-treatment decrease were associated with improvement of LVEF (est. coefficient per one SD: 1.6; 95% CI: -0.05,3.28; p = 0.056, and -1.80; -3.43, -0.18; p = 0.030, respectively) and diminishing of LV end-systolic volume index [mL/m(2)] (-6.83; -11.32; -2.34; p = 0.003, and 5.85; 1.23; -10.46; p = 0.014, respectively). Higher baseline ET-1 and on-treatment increase in TNF-alpha predicted frequent admissions (>1) for cardiac complications (odds ratio per one SD: 1.98; 95% CI: 1.09-3.59; p = 0.025, and 2.07, 1.12-3.84, p = 0.021, respectively) whereas higher baseline BNP was asociated with increased mortality (hazard ratio per one SD: 2.09, 95% CI: 1.26-3.45; p = 0.004). Conclusions: Serum biomarkers may have different roles in prediction of clinical outcomes among HF patients treated de novo with carvedilol. (Cardiol J 2013; 20, 2: 144-151)

Department/s

  • Cardiovascular Research - Hypertension
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health

Publishing year

2013

Language

English

Pages

144-151

Publication/Series

Cardiology Journal

Volume

20

Issue

2

Document type

Journal article

Publisher

Via Medica

Topic

  • Cardiac and Cardiovascular Systems

Keywords

  • heart failure
  • beta-blocker
  • biological markers
  • natriuretic peptides
  • endothelin-1
  • C-reactive protein

Status

Published

Research group

  • Cardiovascular Research - Hypertension

ISBN/ISSN/Other

  • ISSN: 1898-018X