title: Determinants of change in quality of life in the Cardiac Insufficiency Bisoprolol Study in Elderly (CIBIS-ELD).
abstract: OBJECTIVE
  Little is known about parameters that lead to improvement in QoL in individual patients. We analysed the data of the Cardiac Insufficiency Bisoprolol Study in Elderly (CIBIS-ELD) in order to answer the question of how and to what extent change in health-related QoL during up-titration with bisoprolol vs. carvedilol is influenced by clinical and psychosocial factors in elderly patients with heart failure.
  
  
  METHODS
  This is a QoL analysis of CIBIS-ELD, an investigator-initiated multi-center randomised phase III trial in elderly patients (65 years or older) with moderate to severe heart failure. Clinical parameters such as New York Heart Association functional class, heart rate, left ventricular ejection fraction (LVEF), 6-min walk distance, as well as the physical and psychosocial component scores on the short-form QoL health survey (SF36) and depression were recorded at baseline and at the final study visit.
  
  
  RESULTS
  Full baseline and follow-up QoL data were available for 589 patients (292 in the bisoprolol and 297 in the carvedilol group). Mean physical and psychosocial QoL improved significantly during treatment. In regression analyses, changes in both SF36 component scores from baseline to follow-up were mainly predicted by baseline QoL and depression as well as change in depression over time. Changes in cardiac severity markers were significantly weaker predictors.
  
  
  CONCLUSIONS
  Mean QoL increased during up-titration of bisoprolol and carvedilol. Both baseline depression and improvement in depression over time are associated with greater improvement in QoL more strongly than changes in cardiac severity measures.
authors: Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. m.scherer@uke.de
authors: Martin
authors: M
authors: Scherer
authors: Hans-Dirk
authors: HD
authors: Düngen
authors: Simone
authors: S
authors: Inkrot
authors: Elvis
authors: E
authors: Tahirović
authors: Diana Jahandar
authors: DJ
authors: Lashki
authors: Svetlana
authors: S
authors: Apostolović
authors: Frank
authors: F
authors: Edelmann
authors: Rolf
authors: R
authors: Wachter
authors: Goran
authors: G
authors: Loncar
authors: Wilhelm
authors: W
authors: Haverkamp
authors: Aleksandar
authors: A
authors: Neskovic
authors: Christoph
authors: C
authors: Herrmann-Lingen
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000008:administration & dosage*; D000368:Aged; D000369:Aged, 80 and over; D017298:Bisoprolol / Q000627:therapeutic use*; D002227:Carbazoles / Q000627:therapeutic use*; D000077261:Carvedilol; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D016014:Linear Models; D008297:Male; D011412:Propanolamines / Q000627:therapeutic use*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D017298:Bisoprolol