Carvedilol and Cardiac Biomarkers in Dialysis Patients: Secondary Analysis of a Randomized Controlled Trial

Kidney Blood Press Res. 2017;42(6):1033-1044. doi: 10.1159/000485589. Epub 2017 Dec 4.

Abstract

Background/aims: Cardiac biomarkers are associated with cardiac abnormalities and adverse outcomes in dialysis patients. Our aim was to report the effect of the beta-blocker carvedilol on cardiac biomarkers in adult dialysis patients.

Methods: The Beta-Blocker to Lower Cardiovascular Dialysis Events Feasibility Study was a randomized controlled trial comparing carvedilol to placebo. Serum and plasma were collected before the run-in, then 6 and 12 months post-randomization to measure B-type Natriuretic Peptide (BNP), N-terminal BNP (NT-ProBNP), high-sensitivity cardiac troponins I (hs-TnI) and T (hs-TnT), and galectin-3. Left ventricular global longitudinal strain (GLS) was measured by echocardiography at baseline.

Results: Seventy-two participants were recruited of whom 49 completed the run-in and were randomized to carvedilol (n=26) or placebo (n=23). Baseline echocardiography demonstrated median (inter-quartile range) GLS of -14.27% (-16.63 to -11.93). NTproBNP and hs-TnT correlated with GLS (Spearman's rho=0.34 [p=0.018] and rho=0.28 [p=0.049], respectively). Median change scores from baseline to 12 months did not differ significantly between participants with complete biomarker data randomized to carvedilol (n=15) or placebo (n=16) for any biomarkers.

Conclusions: NT-proBNP and hs-TnT were associated with GLS. However, changes in levels of the biomarkers from baseline to 12 months were not different between groups randomized to carvedilol and placebo.

Keywords: Beta-adrenergic receptor blocker; Cardiac biomarkers; Cardiovascular; Dialysis; Echocardiography; Randomized controlled trial.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Adult
  • Aged
  • Biomarkers / blood
  • Carbazoles / pharmacology
  • Carbazoles / therapeutic use*
  • Carvedilol
  • Female
  • Heart Diseases / diagnosis*
  • Heart Diseases / etiology
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Natriuretic Peptide, Brain / drug effects
  • Peptide Fragments / blood
  • Peptide Fragments / drug effects
  • Propanolamines / pharmacology
  • Propanolamines / therapeutic use*
  • Renal Insufficiency, Chronic / complications*
  • Troponin T / blood
  • Troponin T / drug effects

Substances

  • Adrenergic beta-Antagonists
  • Biomarkers
  • Carbazoles
  • Peptide Fragments
  • Propanolamines
  • Troponin T
  • pro-brain natriuretic peptide (1-76)
  • Carvedilol
  • Natriuretic Peptide, Brain