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Objective:To study the efficacy of bisoprolol fumarate tablets combined with tiotropium bromide powder aerosol inhalation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pulmonary heart disease and its effect on high-sensitivity C-reactive protein (hs-CRP) and brain natriuretic peptide (BNP).Methods:From June 2016 to October 2021, 96 patients with AECOPD complicated with pulmonary heart disease admitted to the Affiliated Hospital of Jining Medical University were randomly divided into a control group and an observation group with 48 patients in each group. The patients in both groups were treated with oxygen inhalation, expectorant, cough relieving, asthma relieving and empirical antibiotics. The control group was treated with atomized inhalation of tiotropium bromide powder, and the observation group was treated with bisoprolol fumarate tablets on the basis of the control group. The left ventricular ejection fraction (LVEF), 6-minute walking distance (6MWD), 1 s forced expiratory volume (FEV 1), forced vital capacity (FVC), serum hs-CRP, BNP and other factors were compared between the two groups after treatment, and the total effective rate and adverse drug reaction of the two groups were counted. Results:After treatment, the total effective rates of the observation group and the control group were 91.67%(44/48) and 77.08%(37/48), respectively, with a statistically significant difference ( P<0.05). After treatment, the LVEF of the observation group and the control group were (43.15±6.04)% and (38.96±5.67)% respectively, the 6MWD was (294.86±30.11)m and (261.35±25.88)m, the FEV 1 was (2.36±0.69)L and (1.75±0.52)L, the FVC was (3.58±0.51)L and (2.96±0.45)L, the hs-CRP was (4.47±1.25)mg/L and (7.86±2.01)mg/L, and the BNP was (418.25±32.25)ng/ml and (496.52±43.21)ng/ml; ESR was (16.78±2.11)mm/h and (21.02±1.69)mm/h, ET-1 was (54.26±6.45)ng/ml and (73.21±8.24)ng/ml, and Interleukin 6 was (22.63±8.45)ng/L and (31.85±12.24)ng/L, respectively, with statistical significance ( P<0.05). The total incidence of adverse drug reaction in the observation group and the control group was 8.33%(4/48) and 4.17%(2/48), respectively, with no statistically significant difference ( P>0.05). Conclusions:Bisoprolol fumarate tablets combined with tiotropium bromide powder aerosol inhalation in the treatment of AECOPD complicated with cor pulmonale can improve the heart and lung function of patients, regulate the expression level of hs-CRP, BNP and other factors, improve the efficacy, and do not increase adverse reactions.
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Objective:To investigate the clinical efficacy of sacubitril and valsartan combined with bisoprolol in the treatment of chronic heart failure and its effect on N-terminal pro-brain natriuretic peptide (NT-pro BNP) level.Methods:The clinical data of 89 patients with chronic heart failure who received treatment in Jinan 2 nd People's Hospital from January 2020 to April 2022 were retrospectively analyzed. These patients were divided into Group A ( n = 48) and Group B ( n = 41) according to different treatment methods. Group A was treated with sacubitril and valsartan combined with bisoprolol. Group B was treated with sacubitril and valsartan combined with metoprolol. All patients were treated for 3 months. Clinical efficacy as well as heart function and NT-pro BNP level pre- and post-treatment were compared between the two groups. The incidence of adverse reactions was calculated in each group. Results:Total response rate in group A was significantly higher than that in group B [95.83% (46/48) vs. 82.93% (34/41), χ2 = 4.05, P < 0.05]. After treatment, the left ventricular ejection fraction in both groups increased significantly and the left ventricular ejection fraction in group A was significantly higher than that in group B ( t = 2.19, P < 0.05). After treatment, NT-pro BNP level in group A was (416.51 ± 30.56) ng/L, which was significantly lower than (450.20 ± 35.79) ng/L in group B ( t = 4.79, P < 0.001). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:The efficacy of sacubitril and valsartan combined with bisoprolol in the treatment of chronic heart failure is superior to that of sacubitril and valsartan combined with metoprolol. The former can greatly decrease NT-pro BNP level. Corresponding drugs can be selected for the treatment of chronic heart failure according to the actual needs of patients.
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Objective:To analyze the application value of sakubatril valsartan in the treatment of chronic heart failure (CHF) based on cardiopulmonary test system.Methods:One hundred and thirty-five CHF patients admitted to the Affiliated Hospital of Jining Medical Collegefrom January 2019 to August 2020 were divided into the observation group (67 cases) and the control group (68cases) by random number table method. Both groups were treated with bisoprolol. The observation group was treated with the combination of sakubatril valsartan, and the control group was treated with the combination of benapril. The efficacy and cardiac function indicators of the two groups were compared. The cardiopulmonary exercise test system was used to measure the patient′s maximum exercise time (Tmax), maximum exercise Watt (Wmax), peak volume oxygen (Peak VO 2) and volume of anaerobic threshold oxygen (VO 2AT), and the incidence of adverse reactions were calculated. Results:The total effective rate in the observation group was higher than that in the control group: 92.54% (62/67) vs. 77.94%(53/68), the difference was statistically significant ( χ2 = 5.70, P<0.05). After the treatment, the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and soluble ST2 (sST2) in the observation group were lower than those in the control group: (2 000.47 ± 517.85) ng/L vs. (2 777.39 ± 812.49) ng/L, (0.33 ± 0.10) μg/L vs. (0.37 ± 0.09) μg/L, and the left ventricular ejection fraction (LVEF) was higher than that in the control group: (8.12 ± 6.44)% vs. (41.93 ± 6.73)%, the differences were statistically significant ( P<0.05). After the treatment, the left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVEDs), left ventricular mass index (LVMI), left atrial volume index (LAVI) in the observation group were lower than those in the control group: (55.47 ± 6.93) mm vs. (62.00 ± 7.18) mm, (37.14 ± 6.36) mm vs. (41.35 ± 6.43) mm, (136.76 ± 7.13) mg/m 2 vs. (140.98 ± 7.47) mg/m 2, (28.23 ± 2.59) ml/m 2 vs. (31.98 ± 2.17) ml/m 2; the Tmax, Wmax, PeakVO 2 and VO 2AT in the observation group were higher than those in the control group: (619.08 ± 65.36) s vs. (58.70 ± 52.44) s, (142.96 ± 16.05) W vs. (124.19 ± 13.38) W, (20.00 ± 5.74) ml/(min·kg) vs. (18.13 ± 3.58) ml/(min·kg), (13.89 ± 3.69) ml/(min·kg) vs. (11.23 ± 2.36) ml/(min·kg), the differences were statistically significant ( P<0.05). However, there was no statistically significant in the incidence of adverse reactions between the two groups ( P>0.05). Conclusions:Sakubatril valsartan in the treatment of CHF can not only optimize the efficacy and improve cardiac function, but also benefit cardiac exercise rehabilitation of patients, and not increase the safety risk.
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Objective:To investigate the effect of Jiaomu Gualou Decoction combined with bisoprolol on myocardial microcirculation and oxidative/antioxidant balance in patients with heart failure.Methods:A total of 128 patients with heart failure who met the inclusion criteria from March 2020 to February 2021 in Dagang Hospital of Traditional Chinese Medicine, Binhai New Area, Tianjin were divided into 2 groups by random number table method, with 64 in each group. On the basis of conventional treatment, the control group was given oral bisoprolol, and the study group was given Jiaomu Gualou Decoction and oral bisoprolol. Both groups were treated continuously for 4 weeks. TCM syndrome scores were performed before and after treatment. The left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD), and left ventricular end-diastolic diameter (LVEDD) were detected by ultrasonic diagnostic equipment, and the frequency, duration and total myocardial ischemia load of the 24-hour ECG were recorded. Lipid peroxide (LPO) was detected by fluorescence method, SOD, MDA and GSH-Px were detected by colorimetric method. The adverse events were recorded and clinical response was evaluated.Results:The response rate was 93.75% (60/64) in the study group and 79.69% (51/64) in the control group, and the difference between the two groups was statistically significant ( χ2=5.49, P=0.019). After treatment, the scores of shortness of breath, phlegm, sternocostal fullness, and fatigue in the study group were significantly lower than those in the control group ( t values were 8.48, 8.15, 8.86, and 6.88, respectively, all Ps<0.001). After treatment, the LVEF of the study group [(53.26±5.18)% vs. (48.65±5.27)%, t=4.99] was significantly higher than that of the control group, and the LVESD [(42.59±3.26) mm vs. (46.98±3.55) mm, t=7.29], LVEDD [(52.79±4.15) mm vs. (57.48±4.60) mm, t=6.06] significantly lower than the control group ( P<0.01). After treatment, frequency of ST segment fall [(2.51±0.42) times/24 h vs. (3.79±0.55) times/24 h, t=14.80], duration [(15.26±3.45) min/24 h vs. (22.65±3.71) min/24 h, t=11.67] and total myocardial ischemia load [(25.79±5.13) mm/min vs. (38.02±5.44) mm/min, t=13.09] were significantly lower than those in the control group ( P<0.01). After treatment, the levels of serum GSH-Px and SOD in the study group were significantly higher than those in the control group ( t values were 10.97, 14.37, respectively, all Ps<0.001), while the levels of LPO and MDA were significantly lower than those in the control group ( t values were 7.50, 11.04, respectively, all Ps<0.001). During the treatment period, the incidence of adverse events was 4.69% (3/64) in the study group and 7.81% (5/64) in the control group, with no significant difference between the two groups ( χ2=0.13, P=0.715). Conclusion:The Jiaomu Gualou Decoction combined with bisoprolol can improve the cardiac function and myocardial microcirculation in patients with heart failure, promote the body's oxidation/antioxidant balance, relieve the clinical symptoms of patients, and improve the response effect safely.
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Objective:To investigate the efficacy and safety of Danhong injection combined with Bisoprolol on ventricular arrhythmia in patients with type 2 diabetes mellitus complicated by coronary heart disease. Methods:A total of 100 patents with type 2 diabetes mellitus complicated by coronary heart disease who received treatment in Dezhou Second People's Hospital, China between January and December 2019 were included in this study. They were randomly assigned to receive treatment either with bisoprolol (control group, n = 50) or bisoprolol + Danhong injection (treatment group, n = 50) based on routine treatment. Therapeutic effects, arrhythmia improvement, blood glucose index, islet function index, and adverse reactions during treatment were compared between the control and treatment groups. Results:Total effective rate in the observation group was significantly higher than that in the control group (88.0% vs. 70.0%, χ2 = 4.883, P < 0.05). After treatment, there were significant differences in the number of ventricular premature beats [(1 412.52 ± 587.85) beats/24 hours vs. (2 247.96 ± 761.52) beats/24 hours], paroxysmal supraventricular tachycardia [(46.58 ± 10.12) bursts/24 hours vs. (79.45 ± 12.01) bursts/24 hours], and ST segment depression [(1.24 ± 0.19) mm vs. (1.41 ± 0.24) mm] between the observation and control groups ( t = -6.141, -14.799, -3.927, all P < 0.001). After treatment, fasting blood glucose level, 2-hour postprandial glucose value and glycosylated hemoglobin level in the treatment group were (6.58 ± 1.61) mmol/L, (8.35 ± 1.72) mmol/L, and (6.14 ± 1.58)%, respectively, which were significantly lower than those in the control group [(8.24 ± 1.87) mmol/L, (9.69 ± 1.91) mmol/L, (7.68 ± 1.92)%, t = -4.757, -3.686, -4.379, all P < 0.001]. After treatment, islet beta cell function in the observation group was significantly higher than that in the control group [(56.52 ± 10.28) % vs. (47.96 ± 9.72)%, t = 4.278, P < 0.001). Insulin resistance index in the observation group was significantly lower than that in the control group [(2.06 ± 0.32) vs. (2.54 ± 0.35), t = -7.157, P < 0.001]. After treatment, there was no significant difference in the incidence of adverse reactions between the control and observation groups (12.00% vs. 8.00%), χ2 = 0.444, P > 0.05]. Conclusion:Danhong injection combined with bisoprolol is more effective in treating ventricular arrhythmia in patients with type 2 diabetes mellitus complicated by coronary heart disease than Danhong injection and bisoprolol alone. The combined treatment can reduce the incidence of ventricular arrhythmia, regulate blood glucose level, and improve islet function.
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Resumen Objetivo: Evaluar la equivalencia terapéutica de dos marcas comerciales de bisoprolol -hidroclorotiazida como terapia antihipertensiva. Método: Estudio prospectivo, doble ciego, doble falso, aleatorizado, de grupos paralelos, en el que se evaluó el efecto antihipertensivo de la combinación de bisoprolol-hidroclorotiazida 2,5-6,25 y 5-6,25 mg (comprimidos BHL, formulación test) y bisoprolol-hidroclorotiazida 2,5-6,25 y 5-6,25 mg tabletas (BHM, formulación de referencia), administrados en pacientes con hipertensión arterial. Variables de efectividad: Presiones arteriales medidas mediante mediante esfigmomanómetro de mercurio al inicio y después del período placebo, a las 4 y 8 semanas del inicio del tratamiento; cambios horarios de la presión arterial durante 24 horas, mediante monitorización ambulatoria de la presión arterial. Resultados: El control de los valores de presión arterial se logró en ambas formulaciones, principalmente a partir de la cuarta semana de tratamiento. Los pacientes del grupo test ingresaron con presiones arteriales sistólicas más elevadas. Después del tratamiento no hubo diferencias entre los grupos, a ninguno de los tiempos. La relación V/P del grupo test fue 0,5-1. Los índices de suavidad de ambos fueron mayores a 1,75. Conclusiones: La formulación test de la combinación de bisoprolol-hidroclotiazida demostró acción antihipertensiva similar al compararla con la formulación de referencia.
Abstract Objective: To evaluate the therapeutic equivalence of two commercial brands of bisoprolol -hydrochlorothiazide as antihypertensive therapy. Method: A prospective, double blind, double placebo, randomised, parallel group study was conducted, in which the antihypertensive effect of the bisoprolol -hydrochlorothiazide 2.5 - 6.25 mg and 5 - 6.25 mg (tablets BHL, test formula) and bisoprolol -hydrochlorothiazide 2.5 - 6.25 mg and 5 - 6.25 mg tablets (BHM, reference formula), was compared by administering it to patients with arterial hypertension given to patients with arterial hypertension. Effectivity variables: blood pressures measured using a mercury sphygmomanometer at the beginning and after the placebo period, at 4 weeks and 8 weeks from the start of the treatment; blood pressure hours change during 24 hours using an ambulatory blood pressure monitoring device. Results: Control of the blood pressure values was achieved with both formulas, mainly from the fourth week of treatment. The patients of the test group were admitted with higher systolic blood pressures. After the treatment, there were no differences between the groups at any of the times. The V/P ratio of the test group was 0.5 - 1. The smoothness index in both groups was greater than 1.75 of fit of both was greater than 1.75. Conclusions: The test formula of the bisoprolol-hydrochlorothiazide demonstrated an antihypertensive action similar to that achieved with the reference formula.
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Humans , Male , Female , Adult , Therapeutic Equivalency , Bisoprolol , Hydrochlorothiazide , Blood Pressure , Blood Pressure Monitoring, Ambulatory , HypertensionABSTRACT
Background: Hypertension is considered to be the third most important disease in the list of diseases in the south Asian region. Several trials have shown active treatment of hypertension reduced the incidence of dementia. This study was adopted to understand the cognitive status of patients using beta blockers for hypertension for a period of more than 5 years.Methods: The study was done during the period of August 2018 and September 2018. Patients taking beta blockers for atleast 5 years were included and was made to take the MMSE test which is scored out of 30 marks containing 11 questions, each of varying marks.Results: In the study, 54 patients were included, 8 out of 54 patients taking beta blockers obtained a score of 30 which is 15% of the study population taking beta blockers, 15 out of 54 patients taking beta blockers obtained a score of 29 which corresponds to 28% of the study population, 21 out of 54 individuals taking beta blockers obtained a score of 28 which is 39% of the population taking it, 7 patients taking beta blockers obtained a score of 27 pertaining to 13% of the population. One patient obtained a score of 26 and two patients scored 25 out of 30. The average score obtained was 28.2963.Conclusions: About 18.5% of the study population had scores below the average value of 28 in this study. This population is at higher risk of developing dementia in the future and need follow up.
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Objective To observe the protective effect of bisoprolol against hypoxia/reoxygenation injury of cardiac microvascular endothelial cells and explore the mechanism. Methods Left ventricular of cardiac microvascular endothelial cells (CMECs) were isolated from 8-week-old male C57BL/6N mice. CMECs were randomized into four groups: control group, vehicle group, hypoxia/reoxygenation group (H/R group), hypoxia/reoxygenation + bisoprolol group. The level of cell proliferation, apoptosis, superoxide anion, Cleaved caspase-3 and Nox2 expression were measured in each group. Results Compared with control group, H/R group had lower cell proliferation, higher apoptotic level, more superoxide anion level and the expression of Cleaved caspase-3 and Nox2 (P < 0.05). Furthermore, bisoprolol reversed hypoxia/reoxygenation-induced the decreased cell proliferation, the increased apoptosis, superoxide anion level, Cleaved caspase-3 and Nox2 expression (P < 0.05). Conclusion Bisoprolol can protect CMECs against hypoxia/reoxygenation injury by reducing the expression of Nox 2 that decreases oxidative stress.
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Objective To investigate the influence of Wenxin granules and bisoprolol fumarate combined with aerobic exercise on serum matrix metalloproteinase -1(MMP -1) and N - terminal pro - brain natriuretic peptide (NT - proBNP) levels in patients with unstable angina pectoris. Methods From January 2016 to February 2018, 92 patients with unstable angina pectoris in Lishui Hospital of Traditional Chinese Medicine were selected and randomly divided into control group(n = 46) and study group(n = 46) according to the digital table. On the basis of routine intervention,the control group was given bisoprolol fumarate for 2 weeks and aerobic exercise for 1 month, while the study group was given bisoprolol fumarate,aerobic exercise and Wenxin granules for 2 weeks. The frequency and duration of angina pectoris before and after 1 month of treatment,clinical efficacy,serum MMP -1 and NT - proBNP levels,blood rheology index(plasma viscosity,whole blood high shear viscosity,total blood low - cut viscosity,fibrinogen) and incidence of adverse reactions were observed. Results After 1 month of treatment,the frequency of angina pectoris was lower than that before treatment,and the duration was shorter than that before treatment,which in the study group [(2. 09 ± 0. 65)times/ week,(2. 24 ± 0. 83)min/ time] were better than those in the control group(t1 = 10. 898,t2 =9. 302,all P < 0. 05). The total effective rate of the study group(91. 30％ ) was higher than that of the control group (73. 91％ )(χ2 = 4. 842,P < 0. 05). After 1 month of treatment,the serum levels of MMP - 1 and NT - proBNP in the two groups were lower than those before treatment,which in the study group[(196. 10 ± 55. 01) g/ L,(403. 82 ± 114. 15)ng/ L] were lower than those in the control group ( t1 = 3. 619, t2 = 4. 185, P < 0. 05). At the end of treatment,the plasma viscosity,whole blood high - viscosity,whole blood low - cut viscosity,fibrinogen level in the two groups were lower than those before treatment,which in the study group were lower than those in the control group(all P < 0. 05). The incidence rate of adverse reactions in the study group was 15. 22％ ,which in the control group was 10. 87％ ,there was no statistically significant difference between the two groups (χ2 = 0. 383,P > 0. 05). Conclusion The combination of Wenxin granules, bisoprolol fumarate and aerobic exercise for patients with unstable angina pectoris not only can reduce the frequency of angina pectoris,MMP - 1 and NT - proBNP levels,but also can improve the treatment of disease. Besides,it does not increase the risk of adverse reactions.
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To explore influence of bisoprolol combined benazepril on ECG and left ventricular diastolic function in hypertensive patients with acute heart failure (AHF).Methods :A total of 124 hypertensive patients with AHF were randomly and equally divided into routine treatment group and combined treatment group (received biso‐prolol combined benazepril based on routine treatment ) ,both groups were treated for two months .Therapeutic effect ,ECG indexes ,left ventricular diastolic function indexes ,levels of heart failure and myocardial injury markers etc .before and after treatment were compared between two groups .Results : After two‐month treatment ,total ef‐fective rate of combined treatment group was significantly higher than that of routine treatment group (96. 77% vs. 82. 26%, P＝0.008) ;compared with routine treatment group ,there were significant reductions in QRS wave dura‐tion [ (103. 87 ± 9.70) ms vs.(94.12 ± 8. 93) ms] ,QTc duration [ (432.37 ± 33. 24) msvs .(418.96 ± 29. 64) ms] , plane QRS‐T angle [ (59.75 ± 26. 61)°vs.(48.19 ± 22.30)°] ,mitral annulus late diastolic peak flow velocity (Am) [ (12.84 ± 3.40) cm／svs .(11. 39 ± 3. 11) cm／s] ,plasma levels of N terminal pro brain natriuretic peptide [ (1. 20 ± 0.58) μg／L vs .(0. 75 ± 0.47) μg／L] ,carbohydrate antigen 125 [ (19.10 ± 9.24) U／ml vs.(13.93 ± 7.85) U／ml] ,galectin‐3 [ (4.72 ± 2. 25) μg／L vs .(3.28 ± 1. 65) μg／L] ,cardiac troponin I [ (1.93 ± 0. 97) μg／L vs.(1. 46 ± 0. 85) μg／L] ,and significant rise in mitral early／late diastolic peak flow velocity (E／A) [(1. 18 ± 0.30) vs.(1. 31 ± 0. 28)] and mitral annulus early diastolic peak flow velocity (Em) [ (12.90 ± 3. 76) cm／svs.(14. 49 ± 3.25) cm／s] in combined treatment group , P＜0. 05 or ＜0.01. There was no significant difference in incidence rates of ad‐verse reactions between two groups , P＞0.05 all.Conclusion :Bisoprolol combined benazepril possesses significant therapeutic effect on hypertensive patients with AHF ,and its improving effect on ECG indexes and left ventricular diastolic function is significant .
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Objective To investigate the influence of Wenxin granules and bisoprolol fumarate combined with aerobic exercise on serum matrix metalloproteinase－1(MMP－1) and N－terminal pro－brain natriuretic peptide (NT－proBNP) levels in patients with unstable angina pectoris.Methods From January 2016 to February 2018, 92 patients with unstable angina pectoris in Lishui Hospital of Traditional Chinese Medicine were selected and randomly divided into control group(n=46) and study group(n=46) according to the digital table.On the basis of routine intervention,the control group was given bisoprolol fumarate for 2 weeks and aerobic exercise for 1 month, while the study group was given bisoprolol fumarate,aerobic exercise and Wenxin granules for 2 weeks.The frequency and duration of angina pectoris before and after 1 month of treatment,clinical efficacy,serum MMP－1 and NT－proBNP levels,blood rheology index(plasma viscosity,whole blood high shear viscosity,total blood low－cut viscosity,fibrinogen) and incidence of adverse reactions were observed.Results After 1 month of treatment,the frequency of angina pectoris was lower than that before treatment,and the duration was shorter than that before treatment,which in the study group [(2.09 ± 0.65)times/week,(2.24 ± 0.83)min/time] were better than those in the control group(t1=10.898,t2= 9.302,all P<0.05).The total effective rate of the study group(91.30% ) was higher than that of the control group (73.91% )(χ2 =4.842,P<0.05).After 1 month of treatment,the serum levels of MMP－1 and NT－proBNP in the two groups were lower than those before treatment,which in the study group [(196.10 ± 55.01) g/L,(403.82 ± 114.15)ng/L] were lower than those in the control group ( t1 =3. 619, t2 =4. 185, P <0. 05 ). At the end of treatment,the plasma viscosity,whole blood high－viscosity,whole blood low－cut viscosity,fibrinogen level in the two groups were lower than those before treatment,which in the study group were lower than those in the control group(all P<0.05).The incidence rate of adverse reactions in the study group was 15.22% ,which in the control group was 10.87% ,there was no statistically significant difference between the two groups (χ2 =0.383,P>0.05).Conclusion The combination of Wenxin granules, bisoprolol fumarate and aerobic exercise for patients with unstable angina pectoris not only can reduce the frequency of angina pectoris,MMP－1 and NT－proBNP levels,but also can improve the treatment of disease.Besides,it does not increase the risk of adverse reactions.
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Although the benefits of carvedilol have been demonstrated in the era of percutaneous coronary intervention (PCI), very few studies have evaluated the efficacy of bisoprolol in the secondary prevention of acute myocardial infarction (MI) in patients treated with PCI. We hypothesized that the effect of bisoprolol would not be different from carvedilol in post-MI patients. A total of 13,813 patients who underwent PCI were treated either with carvedilol or bisoprolol at the time of discharge. They were enrolled from the Korean Acute MI Registry (KAMIR). After 1:2 propensity score matching, 1,806 patients were enrolled in the bisoprolol group and 3,612 patients in the carvedilol group. The primary end point was the composite of major adverse cardiac events (MACEs), which was defined as cardiac death, nonfatal MI, target vessel revascularization, and coronary artery bypass surgery. The secondary end point was defined as all-cause mortality, cardiac death, nonfatal MI, any revascularization, or target vessel revascularization. After adjustment for differences in baseline characteristics by propensity score matching, the MACE-free survival rate was not different between the groups (HR=0.815, 95% CI:0.614–1.081, p=0.156). In the subgroup analysis, the cumulative incidence of MACEs was lower in the bisoprolol group in patients having a Killip class of III or IV than in the carvedilol group (HR=0.512, 95% CI: 0.263–0.998, p=0.049). The incidence of secondary end points was similar between the two beta-blocker groups. In conclusion, the benefits of bisoprolol were comparable with those of carvedilol in the secondary prevention of acute MI.
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Humans , Bisoprolol , Coronary Artery Bypass , Death , Incidence , Mortality , Myocardial Infarction , Percutaneous Coronary Intervention , Propensity Score , Secondary Prevention , Survival RateABSTRACT
Objective To explore the curative effect of bisoprolol fumarate combined with wenxin granule for patients with heart failure complicated with premature ventricular.Methods 132 patients with heart failure and premature ventricular complexes were enrolled in our hospital from January 2013 to January 2016,and which patients divided into two groups,bisoprolol fumarate group (Group BF,n =66) accepted bisoprolol fumarate treatment (5 mg/time,1 times/day),and bisoprolol fumarate combined with wenxin granule group (Group BW n =66) adopted wenxin granule (9 g/time,3 times/day) based on the patients in Group BF.After 4 weeks treatment,the curative effect of all patients were evaluated with electrocardiogram monitor and cardiac ultrasound examination,and the plasma NT-proBNP concentration and hemorheology indexes were analyzed compared with pre-treatment.Results The recovery of ventricular function in Group BW was better significantly than that patients in Group BF from the cardiac ultrasound examination (P ＜ 0.05);The total relieved effective of clinical symptom,premature ventricular complexes and heart failure in Group BW were more remarkable than those in Group BF,and which difference from them was significance (P ＜ 0.05);The blood viscosity,plasma viscosity,plasma fibrinogen and plasma NT-proBNP concentration in patients with Group BW were significantly lower than those Group BF (P ＜ 0.05).Conclusions The clinical curative effect of bisoprolol fumarate combined with Wenxin Granule for heart failure complicated with premature ventricular was more remarkable compare with bisoprolol fumarate single treatment,and which possessed the relative safety.
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Objective: To explore influence of bisoprolol on neuroendocrine factor levels in patients with chronic heart failure (CHF), and its therapeutic effects.Methods: A total of 116 CHF patients, who were treated in our department from Jan 2014 to Nov 2015, were selected.According to random number table, they were randomly and equally divided into routine treatment group and bisoprolol group.Left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDd), 6min walking distance (6MWD), serum levels of brain natriuretic peptide (BNP), endothelin (ET) and atrial natriuretic peptide (ANP) before and three months after treatment, and therapeutic effect were compared between two groups.Results: There were no significant difference in above indexes between two groups before treatment, P>0.05 all.Compared with routine treatment group after three-month treatment, there were significant rise in LVEF [(28.13±4.16)% vs.(36.02±5.14)%] and 6MWD [(245.74±44.62)m vs.(315.23±53.12)m], significant reductions in LVEDd [(62.73±10.14)mm vs.(52.82±9.47)mm], serum levels of BNP [(424.51±62.26) ng/ml vs.(324.35±50.46) ng/ml], ET [(80.14±13.25) ng/ml vs.(57.91±10.32) ng/ml] and ANP [(233.24±42.35)ng/ml vs.(164.83±31.26) ng/ml] in bisoprolol group, P<0.05 all.Compared with routine treatment group, there was significant rise in total effective rate (72.4% vs.86.2%) in bisoprolol group, P=0.04.Conclusion: Bisoprolol can significantly reduce BNP, ET and ANP levels, then delay ventricular remodeling and improve cardiac function in patients with chronic heart failure.The therapeutic effect is significant, which is worth extending.
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Objective To study the clinical effect of psychological intervention combined with trimetazidine and bisoprolol in the treatment of left ventricular ejection fraction with heart failure. Methods 40 patients with heart failure were enrolled in this study. 40 patients were divided into control group and study group by digital randomization. There were 20 patients in each group and the patients in the control group.The patients were treated with trimetazidine and bisoprolol. The study group was treated with psychological intervention on the basis of the treatment. The clinical efficacy, adverse reactions, left ventricular ejection fraction and anxiety self-rating were analyzed (SAS), self-rating depression scale (SDS) score. Results The total effective rate of the clinical treatment group was 90.00％ higher than that of the control group (70.00％)P<0.05. There was no significant difference between the two groups in the adverse reaction. The mean left ventricular ejection fraction of the study group was (40.25 ± 5.24), which was significantly lower than that of the control group (43.92 ± 5.30). The scores of the study group were (50.26 ± 1.35) and (51.38 ± 2.61) respectively in SAS and SDS scores (54.36 ± 2.60), (56.98 ± 3.25) in the control group, (P<0.05). Conclusion The patients with left ventricular ejection fraction retention psychological failure in the application of trimetazidine, bisoprolol treatment based on the necessary psychological intervention, can effectively improve the patient's negative emotions, improve patient compliance, and then improve clinical efficacy, clinical significant application value.
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Objective To investigate the effects of bisoprolol on myocardial SERCA2a activity in rats with heart fail-ure.Methods Male SD rats were randomly divided into normal control group (control group), sham operation group ( sham group ) , model group , bisoprolol group ( Bis group ) , captopril group ( Cap group ) and bisoprolol plus captopril group[(Bis+Cap)group], heart failure rat model was induced by intraperitoneal injections of doxorubicin .Distilled water, bisoprolol, captopril or bisoprolol plus captopril were administrated by gastrogavage for 35 days, respectively. Indices of cardiac function and plasma levels of B-type natriuretic peptide ( BNP) were measured , myocardial expres-sion of miR-25-3p was detected by Stem-loop RT-qPCR, myocardial levels of SERCA2a and phospholamban (PLB) were detected by Western blot , myocardial SERCA2a activity was determined by the inorganic phosphorus method . Results Cardiac function in model group decreased significantly while plasma levels of BNP were significantly higher than those of control group ( P<0.01 ) .Myocardial expression of miR-25-3p in model group was significantly higher while myocardial levels of SERCA 2a and PLB,SERCA2a activity were significantly lower than those of con-trol group(P<0.01).Cardiac function in Bis group , Cap group and Bis +Cap group improved significantly while plasma levels of BNP were significantly lower than those of model group ( P<0.01 ) .Myocardial expression of miR-25-3p in Bis group, Cap group and Bis +Cap group were significantly lower while myocardial levels of SERCA2a and PLB were significantly higher than those in model group (P<0.01).The SERCA2a/PLB ratio and SERCA2a activity in Bis group and Bis +Cap group were significantly higher than those of model group ( P<0.05 ) .Conclu-sions Bisoprolol therapy improves cardiac function in rats with heart failure , which may be related to inhibition of myocardial miR-25-3p, increasing myocardial SERCA2a and PLB levels, enhancing SERCA2a activity.
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Objective Toinvestigate the effects of bisoprolol different taking timeon circadian rhythm of heart rate and neuroendocrine factors in patients with chronic heart failure.Methods A total of 96 patients with chronic heart failure and 50 healthy subjects were enrolled as the case group and the control group,and the case group were divided into day taking medicine group (7:00-8:00) and night taking medicine group (19:00-20:00) according to different administration time ofbisoprolol,48 cases in each group.The dynamic ECG results,plasma norepinephrine (NE),angiotensin Ⅱ (Ang Ⅱ),aldosterone and epinephrine levels were compared between the case group and the control group,and the changes of the above indexes before and after treatment were compared between the 2 subgroups.Results Compared with the control group,in the case group,the heart rate of 24 h was significantly accelerated (P ＜ 0.05).The ratio of heart day and night rate increased,and non dipper heart rate increased significantly (P ＜ 0.05);the levels of NE,AngⅡ,aldosterone and epinephrine increased significantly (P ＜ 0.05),and there was no circadian rhythm in the neuroendocrine factors in the case group (P ＞ 0.01).Compared with the before treatment,the heart rate of 24 h were significantly slower in the day taking medicine group and the night taking medicine group (P ＜ 0.05),the rate of heart rate decreased day and night,non dipper heart rate reduction,the levels ofNE,AngⅡ,aldosterone and epinephrine decreased obviously (P ＜ 0.05),and the circadian rhythm was not recovered (P ＞ 0.01).Conclusion Circadian rhythms of heart rate and neuroendocrine factors disappear in patients with chronic heart failure,and taking bisoprolol at night do not significantly restore the circadian rhythm of heart rate and neuroendocrine factors compared with those taken during the day.
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OBJECTIVE: To analyze the cost-effectiveness of irbesartan and bisoprolol using Markov model for the purpose of choosing a secure and effective therapy for hypertension with heart failure. METHODS: Markov state transition model was built to simulate the dynamic changes of the four states (event free, non-fatal myocardial infarction, non-fatal stoke and death) in the hypertension with heart failure patients who received the irbesartan or bisoprolol treatment. Markov model was applied using roll back analysis, Markov cohort simulation to project the costs and effectiveness for the hypertension with heart failure who had been long-term treated with irbesartan or bisoprolol. One way sensitivity analysis was carried out to determine the robustness of this baseline results. RESULTS: The results of cost-effectiveness analysis showed that patients receiving irbesartan cumulative costs and effects were 60 635.48 yuan and 6.22 quality-adjusted life years gained. Patients receiving bisoprolol cumulative costs and effects were 58 185.12 yuan and 6.17 quality-adjusted life years gained and the ICER was 49 007.20 yuan/QALYs. According to the sensitivity analysis, the change of key parameters in the set range did not affect the model results. CONCLUSION: Bisoprolol treatment is more economical than irbesartan treatment for hypertension with heart failure patients. This study could be used as methodology reference of pharmacoeconomics on the hypertension with heart failure diseases for Chinese pharmacoeconomist.
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Objective To evaluate the combination treatment effects of bisoprolol,perindopril and spirono-lactone on chronic cardiac failure caused by rheumatic heart disease.Methods 92 patients were randomly divided into the control group (n=45) and observation group (n=47).The observation group received combination usage of bisoprolol,perindopril and spironolactone,while the control group was given regular treatment.Cardiac functions were measured in both two groups.Results The left ventricular end diastolic diameter ( LVEDD) and left ventricular end systolic diameter (LVESD) were significantly decreased in the observation group(t=4.217,5.842,P<0.05),while left ventricular ejection fraction (LVEF) was significantly increased compared with the control group (t=3.164,P<0.05).Conclusion The combination treatment effects of bisoprolol,perindopril and spironolactone has the privilege effects on chronic cardiac failure caused by rheumatic heart disease,which mainly improves cardiac remodeling.
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Objective To investigate the myocardial remodeling inhibition effect of bisoprolol combined with trimetazidine in the treatment of hypertensive myocardial hypertrophy.Methods 86 cases with hypertension and cardiac hypertrophy in Lingwu People’s Hospital of Ningxia from June 2015 to June 2016 were selected and randomly divided into two groups,43 cases in the control group received routine clinical treatment,43 cases in the experiment group received more with bisoprolol combined with trimetazidine treatment.Blood pressure,ultrasonic cardiogram,levels of serum TNF-α, MMP3 and CRP were compared before and after the treatment.Results Compared with before treatment,levels of blood pressure,IVST,LVPWT,LVMI, MMP3,TNF-αand serum CRP significantly decreased after treatment,and compared with the control group,levels of blood pressure,IVST,LVPWT, LVMI,MMP3,TNF-αand serum CRP in the experiment group were lower,the differences were statistically significant (P<0.05),and the effective rate in the experiment group was higher than the control group ( P<0.05 ) .Conclusion Bisoprolol combined with trimetazidine can effectively inhibit the remodeling of hypertension in patients with myocardial hypertrophy,has good clinical efficacy.