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

Nessler, Jadwiga ; Nessler, Bohdan ; Golebiowska-Wiatrak, Renata ; Palka, Ilona ; Gackowski, Andrzej ; Kitlinski, Mariusz LU ; Melander, Olle LU and Fedorowski, Artur LU (2013) In Cardiology Journal 20(2). p.144-151
Abstract
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... (More)
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) (Less)
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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
heart failure, beta-blocker, biological markers, natriuretic peptides, endothelin-1, C-reactive protein
in
Cardiology Journal
volume
20
issue
2
pages
144 - 151
publisher
Via Medica
external identifiers
  • wos:000317125000007
  • scopus:84885217666
ISSN
1898-018X
DOI
10.5603/CJ.2013.0027
language
English
LU publication?
yes
id
5a19918f-2464-467f-a6ef-64de90c520f2 (old id 3748211)
date added to LUP
2016-04-01 11:07:35
date last changed
2020-07-08 01:38:47
@article{5a19918f-2464-467f-a6ef-64de90c520f2,
  abstract     = {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) &lt; 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 (&gt;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)},
  author       = {Nessler, Jadwiga and Nessler, Bohdan and Golebiowska-Wiatrak, Renata and Palka, Ilona and Gackowski, Andrzej and Kitlinski, Mariusz and Melander, Olle and Fedorowski, Artur},
  issn         = {1898-018X},
  language     = {eng},
  number       = {2},
  pages        = {144--151},
  publisher    = {Via Medica},
  series       = {Cardiology Journal},
  title        = {Serum biomarkers and clinical outcomes in heart failure patients treated de novo with carvedilol},
  url          = {http://dx.doi.org/10.5603/CJ.2013.0027},
  doi          = {10.5603/CJ.2013.0027},
  volume       = {20},
  year         = {2013},
}