Impact of the ß1-adrenoceptor Arg389Gly polymorphism on heart-rate responses to bisoprolol and carvedilol in heart-failure patients.
Clin Pharmacol Ther
; 92(1): 21-8, 2012 Jul.
Article
en En
| MEDLINE
| ID: mdl-22617224
ABSTRACT
This pharmacogenetic substudy of the prospective, double-blind, randomized CIBIS-ELD trial determined the impact of the ß1-adrenoceptor Arg189Gly polymorphism on heart-rate responses to bisoprolol or carvedilol in elderly patients with heart failure (421 with sinus rhythm, 107 with atrial fibrillation). Patients were randomized 11 to bisoprolol or carvedilol with a fortnightly dose-doubling scheme and guideline target doses. Patients with sinus rhythm responded essentially identically to bisoprolol and carvedilol, independent of genotype. Atrial fibrillation patients homozygous for Arg389 had a much smaller response to carvedilol than carriers of at least one Gly389 allele (mean difference 12 bpm, P < 0.00001). Carvedilol up to 2 × 12.5 mg did not reduce heart rate in Arg389Arg homozygotes at all. Interestingly, the immediate response to carvedilol did not differ between genotypes. The Arg389Gly polymorphism has a major impact on the heart-rate response to carvedilol (but not bisoprolol) in patients with heart failure plus atrial fibrillation.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Propanolaminas
/
Fibrilación Atrial
/
Carbazoles
/
Bisoprolol
/
Receptores Adrenérgicos beta 1
/
Insuficiencia Cardíaca
/
Frecuencia Cardíaca
Tipo de estudio:
Clinical_trials
Límite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Clin Pharmacol Ther
Año:
2012
Tipo del documento:
Article
País de afiliación:
Alemania