Resting heart rate control and prognosis in coronary artery disease patients with hypertension previously treated with bisoprolol: a sub-group analysis of the BISO-CAD study.
10.1097/CM9.0000000000000802
- Author:
Yun-Dai CHEN
1
;
Xin-Chun YANG
2
;
Vinh Nguyen PHAM
3
;
Shi-An HUANG
4
;
Guo-Sheng FU
5
;
Xiao-Ping CHEN
6
;
Binh Quang TRUONG
7
;
Yu YANG
8
;
Shao-Wen LIU
9
;
Tian-Rong MA
10
;
Dong-Soo KIM
11
;
Tae-Hoon KIM
12
Author Information
1. Department of Cardiology, China PLA General Hospital, Beijing 100853, China.
2. Department of Cardiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
3. Department of Cardiology, Tam Duc Hospital, Ho Chi Minh City 700000, Vietnam.
4. Department of Cardiology, Affiliated Hospital of Guangdong Medical College, Guangzhou, Guangdong 524001, China.
5. Department of Cardiology, Sir Run Shaw Hospital, Affiliated with School of Medicine Zhejiang University, Hangzhou, Zhejiang 310016, China.
6. Department of Cardiology, West China Hospital, Chengdu, Sichuan 610041, China.
7. Department of Cardiology, University Medical Centre HCMC, Ho Chi Minh 700000, Vietnam.
8. Geriatrics Department, The Second Xiangya Hospital of Central South University, Tianxin, Changsha 410011, China.
9. Department of Cardiology, Shanghai First People's Hospital, Shanghai 200080, China.
10. Department of Medical Affairs, Merck Serono Co., Ltd., Beijing 100016, China.
11. Department of Cardiology, Inje University Busan Paik Hospital, Busan 47392, Korea.
12. Department of Cardiology, Sejong Hospital, Gyeonggi-do 14754, Korea.
- Publication Type:Journal Article
- From:
Chinese Medical Journal
2020;133(10):1155-1165
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Resting heart rate (RHR) is considered as a strong predictor of total mortality and hospitalization due to heart failure in hypertension patients. Bisoprolol fumarate, a second-generation beta-adrenoreceptor blockers (β-blocker) is commonly prescribed drug to manage hypertension. The present study was to retrospectively evaluate changes in the average RHR and its association with cardiovascular outcomes in bisoprolol-treated coronary artery disease (CAD) patients from the CAD treated with bisoprolol (BISO-CAD) study who had comorbid hypertension.
METHODS:We performed ad-hoc analysis for hypertension sub-group of the BISO-CAD study (n = 866), which was a phase IV, multination, multi-center, single-arm, observational study carried out from October 2011 to July 2015 across China, South Korea, and Vietnam. Multivariate regression analysis was used to identify factors associated with incidence of composite cardiac clinical outcome (CCCO), the results were presented as adjusted odds ratio (OR) along with 95% confidence interval (CI) and adjusted P value.
RESULTS:A total of 681 patients (mean age: 64.77 ± 10.33 years) with hypertension from BISO-CAD study were included in the analysis. Bisoprolol improved CCCOs in CAD patients with comorbid hypertension, with RHR <65 and <70 beats/min compared with RHR ≥65 and ≥75 beats/min, respectively, in the efficacy analysis (EA) set. In addition, it lowered RHR in both intent-to-treat (ITT) and EA groups after 6, 12, and 18 months of treatment. Further, RHR 70 to 74 beats/min resulted in significantly higher risk of CCCOs EA set of patients (adjusted OR: 4.34; 95% CI: 1.19-15.89; P = 0.03). Also, events of hospitalization due to acute coronary syndrome were higher when RHR 69 to 74 beats/min compared to RHR <69 beats/min in ITT patients.
CONCLUSION:Bisoprolol can effectively reduce RHR in Asian CAD patients with comorbid hypertension and hence, improve CCCO without affecting their blood pressure.
