Effect of beta blockade on natriuretic peptides and copeptin in elderly patients with heart failure and preserved or reduced ejection fraction: results from the CIBIS-ELD trial

Clin Biochem. 2012 Jan;45(1-2):117-22. doi: 10.1016/j.clinbiochem.2011.11.010. Epub 2011 Dec 2.

Abstract

Background: We sought to investigate the effect of beta-blocker (BB) up-titration on serum levels of NT-proBNP and copeptin in patients with heart failure (HF) with reduced (HFREF) or preserved ejection fraction (HFPEF).

Methods: Serial measurements of NT-proBNP and copeptin were obtained after initiation of BB up-titration in 219 elderly patients with HFREF or HFPEF.

Results: After initial increasing trend of NT-proBNP at 6 weeks in HFREF patients, there was a subsequent decrease at 12 weeks of BB treatment up-titration (p=0.003), while no difference was found compared to baseline levels. In contrast to NT-proBNP, there was a continuous decreasing trend of copeptin in HFREF patients (at 12 weeks: p=0.026). In HFPEF patients, NT-proBNP significantly decreased (p=0.043) compared to copeptin after 12 weeks of BB up-titration.

Conclusions: After 12 weeks of BB optimization copeptin might reflect successful up-titration faster than NT-proBNP in HFREF, while the opposite was found in patients with HFPEF.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / pharmacology
  • Aged
  • Area Under Curve
  • Biomarkers / metabolism
  • Double-Blind Method
  • Echocardiography / methods
  • Female
  • Glycopeptides / biosynthesis*
  • Heart Failure / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / biosynthesis*
  • Peptide Fragments / biosynthesis*
  • ROC Curve
  • Reproducibility of Results
  • Up-Regulation

Substances

  • Adrenergic beta-Antagonists
  • Biomarkers
  • Glycopeptides
  • Peptide Fragments
  • copeptins
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain

Associated data

  • ISRCTN/ISRCTN34827306