title: Clinical status and outcome of Japanese heart failure patients with reduced or preserved ejection fraction treated with carvedilol.
abstract: The effect of beta-blockers in treating Japanese heart failure (HF) patients with preserved left ventricular (LV) ejection fraction (EF) is unclear. This prospective observational study enrolled 1,682 Japanese HF patients who received carvedilol for the first time. Patients were followed for a mean of 1.6 years. The 1,492 patients with baseline LVEF measurements were allocated to the following groups: reduced EF (LVEF < 40%; n = 724), borderline EF (LVEF 4050%; n = 355), and preserved EF (LVEF ≥ 50%; n = 413). Baseline characteristics, New York Heart Association (NYHA) class, change in B-type natriuretic peptide (BNP) level, and long-term outcome were compared among the groups. Patients with preserved EF were more likely to be older, female, and have ischemic etiology and hypertension than patients with reduced EF. Carvedilol maintenance dosage was lower in patients with preserved EF (7.9 mg/day versus 6.6 mg/ day). NYHA class and BNP level were lower in patients with preserved EF at baseline but improved to the same level in all groups at 6 months. After adjusting for baseline characteristics, the hazard ratio for death or hospitalization due to cardiovascular disease in patients with preserved EF versus those with reduced EF was 1.031 (P = 0.847). This study elucidated the characteristics of HF patients given carvedilol in "real world" clinical settings. A comparative controlled study is necessary to elucidate whether the improvements in NYHA and BNP as well as the outcome profile observed in patients with preserved EF were caused by the favorable effects of carvedilol.
authors: Department of Post-Marketing Studies Management, Daiichi Sankyo Co., Ltd., Tokyo, Japan.
authors: Yoshihiro
authors: Y
authors: Mori
authors: Yasuhiro
authors: Y
authors: Nishikawa
authors: Fumiaki
authors: F
authors: Kobayashi
authors: Katsutoshi
authors: K
authors: Hiramatsu
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002227:Carbazoles / Q000008:administration & dosage / Q000009:adverse effects; D000077261:Carvedilol; D016903:Drug Monitoring / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D054539:Medication Therapy Management; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D060735:Pharmacovigilance; D011379:Prognosis; D011412:Propanolamines / Q000008:administration & dosage / Q000009:adverse effects; D016016:Proportional Hazards Models; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013318:Stroke Volume / Q000187:drug effects*; D013995:Time; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D020097:Natriuretic Peptide, Brain