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KMID : 0941820060160020113
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Korean Journal of Clinical Pharmacy
2006 Volume.16 No. 2 p.113 ~ p.122
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Retrospectove Evaluation for effifcacy and Tolerance of beta-blocker in Heart Failure Patients with Concomitant Diabetes
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Jang Sun-Mi
Kang Min-Hee
Lim Sung-Cil
Lee Jun-Seop
Lee Myung-Koo
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Abstract
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Purpose : A retrospective study was performed to assess the efficacy and tolerance of β-blocker administration in patients with heart failure and diabetes.
Method : Records of 164 patients who were treated for the heart failure conditon more than a year were studied retrospectively. Patients were divided into 4 groups based on their diabetes(DM) status and the administration of β-blockers (DM+β-blocker group: 14, DM w/o β-blocker: 19, No DM + β-blocker: 62, No DM + no β-blocker: 69). All patients had been receiving conventional therapy such as digoxin, ACE-Ⅰ, ARB, diuretics, nitrates, aspirin, anticoagulants or lipid-lowering agents. The primary endpoints(death and hospital admission) were recorded during 1 year period and hemodynamic factors (HR, LVEF, SBP, DBP) were obtained from all patient groups before and after 12 months of β-blocker treatment. To evaluate toxicity of β-blocker, SCr, BUN, AST, ALT and Alkaline phosphatase were obtained.
Result : There were less death and hospital admission in DM+ β-blocker group than in DM without β-blocker group(p=0.014). Relative risk of hospital admission in DM + β-blocker group over no DM group was 1.17. Long term β-blocker administration was associated with an improvement of heart rate in patients with DM(P<0.02) with no significant improvement of LVEF, HR and DBP(P<0.01, P<0.03), but not in SBP. The incidence of toxicity was similar between the four group with no significant difference.
Conclusion : Treatment of heart failure patients with β-blocker appears to be beneficial in terms of hospital admission event and several hemodynamic factors. The toxicities of β-blocker treatment were not significant and the treatment is generally well-tolerated in most of the heart failure patients.
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KEYWORD
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CHF, DM, β-blocker efficacy, Toxicity
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