Anemia Is Associated With Blunted Response to β-Blocker Therapy Using Carvedilol ― Insights From Japanese Chronic Heart Failure (J-CHF) Study ―
-
- Nagatomo Yuji
- Sakakibara Heart Institute
-
- Yoshikawa Tsutomu
- Sakakibara Heart Institute
-
- Okamoto Hiroshi
- Sapporo Nango Cardiovascular Clinic
-
- Kitabatake Akira
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
-
- Hori Masatsugu
- Osaka International Cancer Institute
この論文をさがす
抄録
<p>Background:Anemia portends a poor clinical outcome in patients with chronic heart failure (CHF). However, its mechanism remains unknown. We sought to elucidate the effect of anemia on patients with HF with reduced ejection fraction (HFrEF) who receive carvedilol therapy.</p><p>Methods and Results:J-CHF study was a prospective, randomized, multicenter trial that assigned 360 HFrEF patients to 2.5 mg/5 mg/20 mg carvedilol groups according to the target dose. At baseline 70 patients (19%) had anemia ([A]) defined as hemoglobin level (Hb) <13 g/dL (male) or <12 g/dL (female) and the remaining 290 did not ([N]). Allocated and achieved doses of carvedilol were similar. Left ventricular ejection fraction (LVEF) and plasma B-type natriuretic peptide (BNP) level significantly improved in both groups over 56 weeks, but they were smaller in [A] than in [N] (LVEF, P=0.046; BNP, P<0.0001 by ANOVA). Baseline Hb was an independent predictor of absolute change in LVEF (β=0.13, P=0.047) and BNP (β=−0.10, P=0.01). Presence of chronic kidney disease defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2at baseline was not associated with differential response to carvedilol therapy. During 3.8±1.4 years follow-up, group [A] had a higher incidence of the composite endpoint of death, hospitalization for cardiovascular causes including HF compared with [N] (P=0.006). Baseline Hb was an independent predictor of the composite endpoint (hazard ratio 0.86, P=0.04), whereas baseline eGFR was not.</p><p>Conclusions:Our data suggested that anemia was associated with a blunted response to carvedilol in HFrEF patients.</p>
収録刊行物
-
- Circulation Journal
-
Circulation Journal 82 (3), 691-698, 2018
一般社団法人 日本循環器学会
- Tweet
詳細情報 詳細情報について
-
- CRID
- 1390282680084919296
-
- NII論文ID
- 130006394539
-
- NII書誌ID
- AA11591968
-
- ISSN
- 13474820
- 13469843
-
- NDL書誌ID
- 028849901
-
- PubMed
- 28883225
-
- 本文言語コード
- en
-
- データソース種別
-
- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
-
- 抄録ライセンスフラグ
- 使用不可