title: Clinical impact of bisoprolol versus carvedilol in patients undergoing femoropopliteal stenting.
abstract: OBJECTIVE
  Beta-blockers are not considered to be contraindicated in patients with peripheral artery disease, and carvedilol and bisoprolol are commonly used in patients with PAD in Japan. Because there have been only a few reported comparative studies of the effects of different beta-blockers, we compared the clinical outcomes in patients treated with these beta-blockers after undergoing femoropopliteal stenting.
  
  
  METHODS
  Between January 2004 and December 2011, 2911 consecutive patients who had undergone their first femoropopliteal stenting were enrolled in this study. Of these patients, 438 patients(532 limbs) on carvedilol(187 patients, 229 limbs) or bisoprolol(251 patients, 303 limbs) were identified and analyzed retrospectively. The primary outcome was the primary patency and the secondary outcomes were the secondary patency and overall survival and freedom from major adverse limb events(MALE; including any repeated revascularization and major amputation), and these were compared between the groups. The mean follow-up interval of the survivors was 27±17 months.
  
  
  RESULTS
  The primary patency was significantly higher in the bisoprolol-treated group than in the carvedilol-treated group(82.4% vs. 73.6% at 2 years, p=0.0006) as were the secondary patency (93.5% vs. 88.1% at two years, p=0.0004) and freedom from MALE (unadjusted: 79.6% vs. 67.9% at two years, p＜0.0001). However, the two-year overall survival was similar between the groups(91.2% vs. 89.9% at two years, p=0.44). Even after adjusting for baseline differences, bisoprolol was still found to be significantly more effective for the primary patency (HR 0.56, 95% CI 0.37 to 0.83, adjusted p=0.005).
  
  
  CONCLUSIONS
  Our retrospective study suggests that bisoprolol is associated with more favorable outcomes for vessel patency and avoidance of MALE than is carvedilol.
authors.affiliation: Department of Cardiology, Kokura Memorial Hospital.
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Soga
authors.forename: Osamu
authors.initials: O
authors.lastname: Iida
authors.forename: Kenji
authors.initials: K
authors.lastname: Suzuki
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hirano
authors.forename: Daizo
authors.initials: D
authors.lastname: Kawasaki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Shintani
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Suematsu
authors.forename: Terutoshi
authors.initials: T
authors.lastname: Yamaoka
authors.forename: Taketsugu
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Miyashita
authors.forename: Shinya
authors.initials: S
authors.lastname: Okazaki
authors.forename: Norihiko
authors.initials: N
authors.lastname: Shinozaki
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takahashi
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000627:therapeutic use*; D000368:Aged; D017298:Bisoprolol / Q000627:therapeutic use*; D002227:Carbazoles / Q000627:therapeutic use*; D000077261:Carvedilol; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008297:Male; D058729:Peripheral Arterial Disease / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D011150:Popliteal Artery; D011412:Propanolamines / Q000627:therapeutic use*; D011446:Prospective Studies; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D017298:Bisoprolol