NT-proBNP LEVEL CHANGES AFTER COMBINATION THERAPY WITH BISOPROLOL AND ACE-INHIBITOR IN PATIENT WITH HEART FAILURE

Reine Risa Risthanti, Muhammad Aminuddin, Suharjono Suharjono

= http://dx.doi.org/10.20473/fmi.v52i4.5472
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Abstract


Heart failure (HF) is the final common stage of many diseases of the heart. NT-proBNP levels are increased in HF and correlate well with ventricular wall stress and severity of HF. Combination therapy with Bisoprolol and ACE-inhibitor decreases NT-proBNP level in patient with HF. The use of Bisoprolol as a combination with ACE-inhibitor is still dominate in outpatient setting at Dr. Soetomo teaching hospital. The objective of this study is to analyze NT-proBNP level changes as an indicator in cardiac function after combination therapy with Bisoprolol and ACE-inhibitor in patient with HF.Methods: This study was prospective, observational and conducted in outpatient setting. Consecutive patients who meet the inclusion criteria of the study were included. Blood samples were taken at pre and 2 months post combination therapy with Bisoprolol and ACE-inhibitor, then NT-proBNP level was measured with IMMULITE®. There were 14 patients enrolled in this study (7 males, 7 females). The result showed that NT-proBNP 2 months post combination therapy with Bisoprolol and ACE-inhibitor is significantly decreased than baseline with mean baseline of NT-proBNP level is 4191.43 ± 4367.277 pg/ml to 2786.79 ± 2485.199 pg/ml (p=0.025). From a total 14 patients, 9 patients had NT-proBNP decreases >20% (20.1% – 56.4%) and 3 patients had NT-proBNP decreases <20% (1.8%, 6.6%, and 12.4%). There were 2 patients with NT-proBNP increases >40% (43.4% and 40.4%). In conclusion, there was a significant decreases in NT-proBNP level after 2 months combination therapy with Bisoprolol and ACE-inhibitor in patient with HF.

Keywords


NT-proBNP; heart failure; Bisoprolol; Angiotensin-converting enzyme inhibitors

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References


Amir O, Paz H, Ammar R, Yaniv N, Schliamser JE, Lewis BS (2008). Usefulness and predictive value of circulating NT-proBNP levels to stratify patients for referral and priority treatment in a specialized outpatient heart failure center. Isr Med Assoc J 10, 109-112

Barrese V and Taglialatela M (2013). New advances in beta-blocker therapy in heart failure. Front Physiol 4, 323

Bettencourt PM (2005). Clinical usefulness of B-type natriuretic peptide measurement: present and future perspectives. Heart 91, 1489-1494

Bonow RO, Mann DL, Zipes DP, Libby P (2012). Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed, Philadelphia, Elsevier Saunders.

Brunton LL (2011). Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 12th ed, New York, McGraw-Hill Companies

Daniels LB and Maisel AS (2007). Natriuretic peptides. Journal of The American College of Cardiology 50, 2357-2368

Davutoglu V, Celik A, Aksoy M, Sezen Y, Soydinc S, Gunay N (2005). Plasma NT-proBNP is a potential marker of disease severity and correlates with symptoms in patients with chronic rheumatic valve disease. Eur J Heart Fail 7, 532-536

Jackson G, Gibbs CR, Davies MK, Lip GYH (2000). Pathophysiology. British Medical Journal 320, 167-170

Januzzi JL (2012). The role of natriuretic peptide testing in guiding chronic heart failure management: review of available data and recommendations for use. Archives of Cardiovascular Diseases 105, 40-50

Longo DL, Kasper DL, Fauci AS, Hauser SL, Loscalzo J (2012). Harrison’s Principles of Internal Medicine, 18th ed, New York, McGraw-Hill Companies

McMurray, Stamatis A, et al (2012). ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. European Heart Journal 33, 1787-1847

Miller WL, Hartman KA, Grill DE, Burnett JC Jr, Jaffe AS (2009). Only large reductions in concentrations of natriuretic peptides (BNP and NT-proBNP) are associated with improved outcome in ambulatory patients with chronic heart failure. Clin Chem 55, 78-84

Newby DE, Grubb NR, Bradbury A (2010). Cardiovascular disease. In: Colledge NR, Walker BR, Ralston SH. Davidson’s Principles and Practice of Medicine, 21th ed, Philadelphia, Elsevier Limited

Olsson LG, Swedberg K, Cleland JG, Spark PA, Komajda M, Metra M, Torp-Pedersen C, Remme WJ, Scherhag A, Poole-Wilson P; COMET Investigators (2007). Prognostic importance of plasma NT-pro BNP in chronic heart failure in patients treated with a beta-blocker: results from the Carvedilol Or Metoprolol European Trial (COMET) trial. Eur J Heart Fail 9, 795-801

Porapakkham P, Porapakkham P, Zimmet H, Billah B, Krum H (2010). B-type natriuretic peptide-guided heart failure therapy: A meta-analysis. Arch Intern Med 170, 507-514

Wang F, Xu ZM, Wang L, Bian WY, Jia X, Duan B, Li W, Li YS (2005). Beneficial neurohormonal profiles of beta-blockades in chronic left heart failure. Zhonghua Nei Ke Za Zhi 44, 490-494


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