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Submitted
14 August 2017
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14 August 2017
Published
14 August 2017
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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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  • Folia Medica Indonesiana is a scientific peer-reviewed article which freely available to be accessed, downloaded, and used for research purposes. Folia Medica Indonesiana (p-ISSN: 2541-1012; e-ISSN: 2528-2018) is licensed under a Creative Commons Attribution 4.0 International License. Manuscripts submitted to Folia Medica Indonesiana are published under the terms of the Creative Commons License. The terms of the license are:

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How to Cite
Risthanti, R. R., Aminuddin, M., & Suharjono, S. (2017). NT-proBNP LEVEL CHANGES AFTER COMBINATION THERAPY WITH BISOPROLOL AND ACE-INHIBITOR IN PATIENT WITH HEART FAILURE. Folia Medica Indonesiana, 52(4), 258–263. https://doi.org/10.20473/fmi.v52i4.5472
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References

  1. 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
  2. Barrese V and Taglialatela M (2013). New advances in beta-blocker therapy in heart failure. Front Physiol 4, 323
  3. Bettencourt PM (2005). Clinical usefulness of B-type natriuretic peptide measurement: present and future perspectives. Heart 91, 1489-1494
  4. Bonow RO, Mann DL, Zipes DP, Libby P (2012). Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed, Philadelphia, Elsevier Saunders.
  5. Brunton LL (2011). Goodman and Gilman's The Pharmacological Basis of Therapeutics, 12th ed, New York, McGraw-Hill Companies
  6. Daniels LB and Maisel AS (2007). Natriuretic peptides. Journal of The American College of Cardiology 50, 2357-2368
  7. 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
  8. Jackson G, Gibbs CR, Davies MK, Lip GYH (2000). Pathophysiology. British Medical Journal 320, 167-170
  9. 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
  10. Longo DL, Kasper DL, Fauci AS, Hauser SL, Loscalzo J (2012). Harrison's Principles of Internal Medicine, 18th ed, New York, McGraw-Hill Companies
  11. 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
  12. 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
  13. 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
  14. 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
  15. 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
  16. 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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